Anti-inflammatory effects and safety of omega-3 fatty acids in haemodialysis: A systematic review and meta-analysis
Blair C, Slee A, McKeaveney C, Maxwell AP, Awan F, Brown M, Davenport A, Fogarty D, Fouque D, Johnston W, Kalantar-Zadeh K, Mullan R, Noble H, Porter S, Seres DS, Shields J, Swaine I, Witham M, Reid J
Clinical nutrition ESPEN · 0 citas
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Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Solo mecanismos
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute for Health and Care Research
- Gobierno
- NIHR Newcastle Biomedical Research Centre
Según 2 financiadores declarados.
Publicación
- Publicado
- 2026-02-13 · Clin Nutr ESPEN · vol. 72 · pág. 102957
- Editorial
- Elsevier BV
- Citado
- 1 cita · más que el 83% de estudios similares · 2.8× el promedio de su campo
- Referencias
- 58 trabajos
- Acceso
- Acceso abierto (copia en repositorio) · CC-BY
- Áreas de investigación
- Fatty Acid Research and Health · Dialysis and Renal Disease Management · Parathyroid Disorders and Treatments
- Palabras clave
- Triglyceride, Ethyl ester, Fatty acid, Clinical trial, Triglycerides blood
- MeSH
- humans, inflammation, fatty acids, omega-3, docosahexaenoic acids, eicosapentaenoic acid, c-reactive protein, anti-inflammatory agents, renal dialysis, dietary supplements
19 autores
- Carolyn Blair🇬🇧 · autor de correspondenciaQueen's University Belfast
- Adrian J. Slee🇬🇧 · autor de correspondenciaUniversity College Hospital; University College London
- Clare McKeaveney🇬🇧 · autor de correspondenciaQueen's University Belfast
- A. P. Maxwell🇬🇧 · autor de correspondenciaQueen's University Belfast
- Faizan Awan · autor de correspondencia
- Malcolm Brown🇬🇧 · autor de correspondenciaUniversity of Ulster
- Andrew Davenport🇬🇧 · autor de correspondenciaThe Royal Free Hospital; University College London
- Damian G. Fogarty🇬🇧 · autor de correspondenciaBelfast Health and Social Care Trust; University of Ulster; Belfast City Hospital
- Denis Fouque🇫🇷🇺🇸 · autor de correspondenciaLyon 1 Université; Lyon College
- William M. Johnston🇬🇧 · autor de correspondenciaKidney Care UK
- Kamyar Kalantar‐Zadeh🇺🇸 · autor de correspondenciaColorado Kidney Care
- Robert N. Mullan🇬🇧 · autor de correspondenciaNorthern Health and Social Care Trust
- Helen Rose Noble🇬🇧 · autor de correspondenciaQueen's University Belfast
- Sam Porter🇬🇧 · autor de correspondenciaBournemouth University
- David S. Seres🇺🇸 · autor de correspondenciaColumbia University Irving Medical Center
- Joanne Shields🇬🇧 · autor de correspondenciaBelfast Health and Social Care Trust; University of Ulster; Belfast City Hospital
- Ian Swaine🇬🇧 · autor de correspondenciaUniversity of Greenwich
- Miles Witham🇬🇧 · autor de correspondenciaNIHR Newcastle Biomedical Research Centre; Newcastle Hospitals - Campus for Ageing and Vitality
- Joanne Reid🇬🇧 · autor de correspondenciaQueen's University Belfast
Resumen
El texto original del estudio, en el idioma en que se publicó.
Introduction
Evidence on the anti-inflammatory effects and safety of omega-3 fatty acid supplementation in haemodialysis (HD) patients remains limited, particularly regarding the influence of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) dose, composition, and source.
Methods
We searched PubMed (n = 345), CENTRAL (n = 148) and EMBASE (n = 706) to July 2025. Studies were screened using Covidence, risk of bias was assessed using the Cochrane ROB 1 tool, and analyses were conducted in Review Manager 9.5.1. Only trials reporting C-reactive protein (CRP) were included. Pre-planned subgroup analyses examined formulation type, total daily dose, active ingredient dose, and DHA:EPA composition. Random-effects models were used to generate pooled standardised mean differences (SMDs), with heterogeneity assessed using I2. A sensitivity analysis excluded studies at high risk of bias. The protocol is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/JCBHN).
Results
Thirteen studies (n = 678) were included (12 in meta-analyses). Two studies were judged high risk of bias, one unclear, and the remainder low risk. Adverse events were poorly reported: eight trials did not report any events, while five described only mild, transient effects (e.g., diarrhoea). Omega-3 fatty acids reduced CRP more than comparators across triglyceride formulations (SMD -0.62, 95 % CI -1.22 to -0.03; P = 0.04, I2 = 74 %); in the 2 = 29 %); and in the 2 = 31 %). No statistically significant differences were observed between subgroups. Sensitivity analyses did not materially change the results.
Conclusion
A daily dose <2000 mg of omega-3 fatty acids in natural triglyceride form appears more effective than synthetic ethyl ester formulations for lowering CRP in HD patients. Larger, high-quality trials are required to confirm therapeutic benefit, determine optimal dosing, and clarify the ideal EPA:DHA composition for this population.
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