Effect of n-3 fatty acids from fish oil on hemostasis, blood pressure, and lipid profile of dialysis patients

• Published in: Journal of the American Society of Nephrology 1992-05, Vol.2 (11), p.1634-1639
• Main Authors: Donnelly, S M, Ali, M A, Churchill, D N
• Format: Article
• Language: English
• Subjects: Adult; Aged; Blood Pressure - drug effects; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Docosahexaenoic Acids; Drug Combinations; Eicosapentaenoic Acid; Fatty Acids, Omega-3 - pharmacology; Female; Fish Oils - pharmacology; Hemostasis - drug effects; Humans; Kidney Failure, Chronic - therapy; Lipids - blood; Male; Middle Aged; Peritoneal Dialysis - adverse effects; Renal Dialysis - adverse effects
• ISSN: 1046-6673
• DOI: 10.1681/ASN.V2111634

Dialysis patients have an inordinate risk of cardiovascular events. Fish oils, rich in n-3 fatty acids, are believed to be beneficial in the prevention of atherosclerosis and thrombosis. Hence, the use of fish oils deserves consideration as a preventative or therapeutic intervention in dialysis patients. The suggestion has been made that n-3 fatty acids could increase the risk of bleeding, and thus, the safety of the use of these agents in dialysis patients must be established before long-term studies are undertaken. This study addresses the effect of n-3 fatty acids on the hemostatic profile of dialysis patients. Sixteen patients on chronic dialysis therapy were randomized to fish oil (MaxEPA) or placebo (olive oil) in a double-blind cross-over study. They received 3.6 g of n-3 fatty acids for 4 wk. Bleeding times were 4.8 +/- 0.4 min on MaxEPA and 4.5 +/- 0.3 min on placebo. Platelet aggregation to low-dose ADP or collagen also remained unchanged. There was a trend to lower serum triglyceride levels (2.7 +/- 0.5 versus 3.4 +/- 0.6 mmol/L, fish oil versus placebo) that did not reach statistical significance. Gastrointestinal side effects occurred in 10 of the 16 subjects and were severe in 5 patients. These side effects occurred in both the olive oil and the fish oil groups. The study had a 95% chance of detecting a clinically doubling significant increase in bleeding time, i.e., beta error less than 5%. In conclusion, n-3 fatty acids do not introduce a clinically important risk of bleeding for patients with end-stage renal disease.