Badalamenti S, Salerno F, Lorenzano E, Paone G, Como G, Finazzi S, Sacchetta A C, Rimola A, Graziani G, Galmarini D
Division of Nephrology and Dialysis, IRCCS Ospedale Maggiore, Milano, Italy.
Hepatology. 1995 Dec;22(6):1695-71.
Nephrotoxicity is the main untoward effect of cyclosporine (CsA) treatment. Experimental and clinical data suggest that dietary supplementation with fish oil may lessen cyclosporine nephrotoxicity, possibly by lowering renal thromboxane (Tx) production. We have studied the renal effects of a daily supplementation for 2 months of 12 g fish oil (18% C20:5 n-3 eicosapentaenoic acid [EPA] and 12% C22:6 n-3 docosahexanoic acid [DHA]) in a placebo-controlled (12 g corn oil), prospective, randomized, double-blind study of stable CsA-treated liver transplant recipients. Thirteen patients ingested corn oil capsules and 13 fish oil. Compliance with dietary regimen was confirmed by fatty acid chromatography that showed increased plasma concentrations of EPA (from 0.4 +/- 0.02% to 4.6 +/- 0.5%, P < .0001) and DHA (from 1.8 +/- 0.2% to 3.9 +/- 0.1%, P < .0001) in the fish oil group and increased plasma concentration of linoleic acid (C18:2 n-6) in the corn oil group (from 25 +/- 2% to 28.4 +/- 2%, P < .001). At the end of the 2 months of the study, in the fish oil group the effective renal plasma flow increased by 22% (P = .012), the glomerular filtration rate increased by 33% (P = .057), the renal blood flow increased by 17% (P = .024), and the calculated total renal vascular resistances decreased by 20% (P = .034). In contrast, none of these parameters changed in the corn oil group. The renal functional reserve determined during L-arginine infusion, plasma renin activity (PRA), and plasma aldosterone (PA) remained unchanged during the study in either group.(ABSTRACT TRUNCATED AT 250 WORDS)
肾毒性是环孢素（CsA）治疗的主要不良反应。实验和临床数据表明，饮食中补充鱼油可能会减轻环孢素的肾毒性，这可能是通过降低肾脏血栓素（Tx）的生成来实现的。我们在一项安慰剂对照（12克玉米油）、前瞻性、随机、双盲研究中，对稳定接受CsA治疗的肝移植受者进行了为期2个月、每日补充12克鱼油（18%的二十碳五烯酸 [EPA] 和12%的二十二碳六烯酸 [DHA]）的肾脏效应研究。13名患者摄入玉米油胶囊，13名患者摄入鱼油。通过脂肪酸色谱法确认了对饮食方案的依从性，结果显示鱼油组中EPA的血浆浓度升高（从0.4±0.02%升至4.6±0.5%，P<.0001）和DHA的血浆浓度升高（从1.8±0.2%升至3.9±0.1%，P<.0001），玉米油组中亚油酸（C18:2 n-6）的血浆浓度升高（从25±2%升至28.4±2%，P<.001）。在研究的2个月末，鱼油组的有效肾血浆流量增加了22%（P=.012），肾小球滤过率增加了33%（P=.057），肾血流量增加了17%（P=.024），计算得出的总肾血管阻力降低了20%（P=.034）。相比之下，玉米油组这些参数均未改变。在两组研究期间，精氨酸输注期间测定的肾功能储备、血浆肾素活性（PRA）和血浆醛固酮（PA）均保持不变。（摘要截断于250字）
