Department of Nursing, Hungkuang University, Taichung 403, Taiwan.
Department of Nutrition, Chung Shan Medical University, Taichung 402, Taiwan.
Medicina (Kaunas). 2022 Jun 13;58(6):796. doi: 10.3390/medicina58060796.
Background and Objectives: Chronic kidney disease-associated pruritus (CKD-aP) is a common symptom in hemodialysis patients. A frequent and intense itching sensation largely torments patients, impacts quality of life outcomes, and it has an independent association with mortality. The objective of this study is to investigate the effects of oral supplementation with omega-3 polyunsaturated fatty acid (omega-3 PUFA) on circulating interleukin-6 (IL-6), cardiometabolic parameters, skin moisturization, and the consequent symptoms of pruritus in hemodialysis patients. Materials and Methods: Volunteers on maintenance hemodialysis with very severe pruritus symptoms were enrolled in this prospective cohort study. Subjects were instructed to consume 1000 mg fish oil once daily for 3 months. Pruritus scoring, skin moisture, plasma IL-6, and cardiometabolic parameters were measured at baseline, and at the first, second, and third month post-supplementation with fish oil for assessment of the clinical significance. Results: A total of 27 patients who had a mean age of 67.33 ± 11.06 years and 3.98 ± 3.23 years on hemodialysis completed the study. Supplementation with omega-3 PUFA significantly decreased IL-6 levels (p < 0.001), but increased the levels of c-reactive protein (CRP) (p < 0.05). Evaluation of the cardiovascular risk showed significant (all p < 0.001) decreases in the total cholesterol (CHO), low-density lipoprotein (LDL), and triglycerides (TG) levels, and an increase in the high-density lipoprotein (HDL) level. A significant decrease in plasma creatinine (CR) was observed (p < 0.001), but the decrease was limited. Supplementation with omega-3 PUFA significantly improved (all p < 0.001) skin hydration on both the face and arms, as well as disease-related symptoms of pruritus. Conclusion: Omega-3 PUFA supplementation improved inflammation, renal function, cardiovascular parameters, dry skin conditions, and the consequent symptoms of pruritus in hemodialysis patients.
慢性肾脏病相关瘙痒症（CKD-aP）是血液透析患者常见的症状。频繁且强烈的瘙痒感严重折磨着患者，影响生活质量，且与死亡率有独立相关性。本研究旨在探讨口服ω-3 多不饱和脂肪酸（ω-3 PUFA）补充剂对血液透析患者循环白细胞介素-6（IL-6）、心血管代谢参数、皮肤保湿以及瘙痒症状的影响。
本前瞻性队列研究纳入了伴有严重瘙痒症状的维持性血液透析志愿者。患者每天口服 1000mg 鱼油，持续 3 个月。在基线时、鱼油补充的第 1、2、3 个月时评估瘙痒评分、皮肤水分、血浆 IL-6 和心血管代谢参数，以评估临床意义。
共有 27 名患者完成了本研究，他们的平均年龄为 67.33±11.06 岁，血液透析时间为 3.98±3.23 年。ω-3 PUFA 补充显著降低了 IL-6 水平（p＜0.001），但增加了 C 反应蛋白（CRP）水平（p＜0.05）。心血管风险评估显示，总胆固醇（CHO）、低密度脂蛋白（LDL）和甘油三酯（TG）水平显著降低（均 p＜0.001），高密度脂蛋白（HDL）水平升高。血浆肌酐（CR）显著降低（p＜0.001），但降低幅度有限。ω-3 PUFA 补充显著改善了面部和手臂的皮肤水分，以及与疾病相关的瘙痒症状（均 p＜0.001）。
ω-3 PUFA 补充改善了血液透析患者的炎症、肾功能、心血管参数、皮肤干燥状况以及瘙痒症状。
