Evaluation of the Effect of Omega-3 Fatty Acids Supplementation on Pediatric Patients Undergoing Hemodialysis

Abstract

Introduction: Chronic kidney disease (CKD) is a worldwide public health problem in the pediatric population. Patients with CKD die of cardiovascular causes and infections rather than from renal disease. Cardiovascular disease (CVD) is the leading cause of death in patients with CKD, especially those with end stage renal disease (ESRD) on maintenance hemodialysis (HD). Omega-3 fatty acids are beneficial in preventing atherosclerosis and many studies have proven its ability to reduce the cardiovascular events. HD patients are succeptible to inadequate omega-3 intake due to renal dietary restrictions. Thus, the aim of this study was to evaluate the effect of omega-3 fatty acids supplementation on serum lipid profile, oxidative stress markers, endothelial dysfunction marker, inflammatory marker and clinical manifestations of cardiovascular complications in pediatric patients undergoing HD. Methods: This single-blinded randomized placebo-controlled trial included forty nine pediatric patients on maintenance HD. Patients were randomly divided into two groups. Twenty five patients received 1 g oral omega-3 capsule once daily for 16 weeks (Group A), while twenty four patients received 1 g matching oral placebo capsule once daily for 16 weeks (Group B). Blood samples were taken from patients of both groups at baseline and after 16 weeks of supplementation. Serum samples were assessed for several parameters including: total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), lowdensity lipoprotein cholesterol (LDL-C), malondialdehyde (MDA), superoxide dismutase (SOD), C-reactive protein (CRP) and nitric oxide (NO) levels. Red blood cells were assessed for glutathione peroxidase (GP). Cardiovascular manifestations including shortness of breath, palpitations, and feeling of fainting or dizziness were also examined at baseline and at the end of the study. Results: By the end of the study, children receiving omega-3 capsules (Group A) showed a highly significant reduction in TC and a highly significant increase in GP and SOD when compared to those receiving placebo capsules. There was also a highly significant reduction in the ix number of children suffering from palpitations in omega-3 group. No significant differences between the 2 groups were observed in other measured parameters. Conclusion: The current study suggested that the administration of omega-3 to children on regular HD may have a beneficial effect on serum lipid profile, oxidative stress and clinical manifestations of cardiovascular complications. Keywords: Chronic kidney disease, Hemodialysis, pediatric, omega-3, Lipid profile, Oxidative stress, cardiovascular