The role of fish oil/omega-3 fatty acids in the treatment of IgA nephropathy

James V. Donadio, Joseph Peter Grande

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Beneficial effects of omega-3 polyunsaturated fatty acids (n-3 PUFA) have been reported in recent epidemiologic studies and randomized clinical trials in a variety of cardiovascular and autoimmune diseases. Fish and marine oils are the most abundant and convenient sources of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the two major n-3 fatty acids that serve as substrates for cyclooxygenase and lipoxygenase pathways leading to less potent inflammatory mediators than those produced through the n-6 PUFA substrate, arachidonic acid. N-3 PUFA can also suppress inflammatory and/or immunologic responses through eicosanoid-independent mechanisms. Although the pathophysiology of IgA nephropathy is incompletely understood, it is likely that n-3 PUFA prevents renal disease progression by interfering with a number of effector pathways triggered by mesangial immune-complex deposition. In addition, potential targets of n-3 PUFA relevant to renal disease progression could be similar to those involved in preventing the development and progression of cardiovascular disease by lowering blood pressure, reducing serum lipid levels, decreasing vascular resistance, or preventing thrombosis. In IgA nephropathy, efficacy of n-3 PUFA contained in fish oil supplements has been tested with varying results. The largest randomized clinical trial performed by our collaborative group provided strong evidence that treatment for 2 years with a daily dose of 1.8 g of EPA and 1.2 g of DHA slowed the progression of renal disease in high-risk patients. These benefits persisted after 6.4 years of follow up. With safety, composition, and dosing convenience in mind, we can recommend two products that are available as pharmaceutical-grade fish-oil concentrates, Omacor (Pronova Biocare, Oslo, Norway) and Coromega (European Reference Botanical Laboratories, Carlsbad, CA).

Original languageEnglish (US)
Pages (from-to)225-243
Number of pages19
JournalSeminars in Nephrology
Volume24
Issue number3
DOIs
StatePublished - May 2004

Fingerprint

Fish Oils
Omega-3 Fatty Acids
Immunoglobulin A
Disease Progression
Eicosapentaenoic Acid
Docosahexaenoic Acids
Kidney
Therapeutics
Cardiovascular Diseases
Randomized Controlled Trials
Lipoxygenase
Eicosanoids
Military Personnel
Norway
Prostaglandin-Endoperoxide Synthases
Antigen-Antibody Complex
Unsaturated Fatty Acids
Arachidonic Acid
Vascular Resistance
Autoimmune Diseases

ASJC Scopus subject areas

  • Nephrology

Cite this

The role of fish oil/omega-3 fatty acids in the treatment of IgA nephropathy. / Donadio, James V.; Grande, Joseph Peter.

In: Seminars in Nephrology, Vol. 24, No. 3, 05.2004, p. 225-243.

Research output: Contribution to journalArticle

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