2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by DONADIO, J. V. Articles by SPENCER, D. C. Search for Related Content PubMed PubMed Citation Articles by DONADIO, J. V., JR. Articles by SPENCER, D. C.

The Long-Term Outcome of Patients with IgA Nephropathy Treated with Fish Oil in a Controlled Trial

JAMES V. DONADIO, JR.^*, JOSEPH P. GRANDE^*,, ERIK J. BERGSTRALH, RICHARD A. DART^§, TIMOTHY S. LARSON^*, DOROTHY C. SPENCER^* and THE MAYO NEPHROLOGY COLLABORATIVE GROUP^,a

^* Division of Nephrology, Department of Internal Medicine, Mayo Clinic & Foundation, Rochester, Minnesota
Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic & Foundation, Rochester, Minnesota
Section of Biostatistics, Mayo Clinic & Foundation, Rochester, Minnesota
^§ Department of Hypertension and Nephrology, Marshfield Clinic, Marshfield, Wisconsin.

Correspondence to Dr. James V. Donadio, Jr., Mayo Foundation, 200 First Street SW, Rochester, MN 55905. Phone: 507-266-1047; Fax: 507-266-7891; E-mail: donadio.james{at}mayo.edu

Abstract

Abstract. It was reported previously that dietary fish oil supplementation retarded the progression of renal disease in patients with IgA nephropathy in a multicenter, placebo-controlled, randomized, 2-yr clinical trial. The aim of this study was to determine the long-term influence of fish oil treatment on renal progression in observations on the study cohort of 106 patients extending beyond the 2-yr trial. Renal function was assessed by serial serum creatinine and 24-h urine protein measurements. Vital, end-stage renal disease (ESRD), and BP status and treatment beyond completion of the 2-yr trial were determined. As in the trial, the primary end point was an increase of 50% or more in the serum creatinine, and the secondary end point was ESRD. After a mean follow-up of 6.4 yr, 46 patients—17 in the fish oil group versus 29 in the placebo group—reached the primary end point (P = 0.002), and 27 patients—eight in the fish oil group versus 19 in the placebo group—developed ESRD (P = 0.009). At the end of the 2-yr trial, 75 patients (45 fish oil, 30 placebo) remained at risk for the primary end point. This is also when the double-blind part of the trial ended, allowing physicians to stop supplements, switch original placebo-assigned patients to fish oil, and continue fish oil in original fish oil-assigned patients. A significantly greater number of nonsupplemented placebo patients developed the primary end point (P = 0.02) and ESRD (P = 0.003) compared with long-term supplemented fish oil patients. Conversely, more fish oil-supplemented patients had stable renal function than nonsupplemented patients (P = 0.02). By intention, BP control, primarily treated with angiotensin-converting enzyme inhibition, was equal in the fish oil and placebo groups. Proteinuria was modestly reduced in both groups. It is concluded that early and prolonged treatment with fish oil slows renal progression for high-risk patients with IgA nephropathy.

This article has been cited by other articles:

				P. M. Ferraro, G. F. Ferraccioli, G. Gambaro, P. Fulignati, and S. Costanzi Combined treatment with renin-angiotensin system blockers and polyunsaturated fatty acids in proteinuric IgA nephropathy: a randomized controlled trial Nephrol. Dial. Transplant., August 6, 2008; (2008) gfn454v1. [Abstract] [Full Text] [PDF]

				M. M. Diaz Encarnacion, G. M. Warner, C. E. Gray, J. Cheng, H. K. H. Keryakos, K. A. Nath, and J. P. Grande Signaling pathways modulated by fish oil in salt-sensitive hypertension Am J Physiol Renal Physiol, June 1, 2008; 294(6): F1323 - F1335. [Abstract] [Full Text] [PDF]

				R. J. Hogg, L. Fitzgibbons, C. Atkins, N. Nardelli, R. C. Bay, and for the North American IgA Nephropathy Study Group Efficacy of Omega-3 Fatty Acids in Children and Adults with IgA Nephropathy Is Dosage- and Size-Dependent Clin. J. Am. Soc. Nephrol., November 1, 2006; 1(6): 1167 - 1172. [Abstract] [Full Text] [PDF]

				J. V. Donadio, E. J. Bergstralh, D. M. Bibus, and J. P. Grande Is Body Size a Biomarker for Optimizing Dosing of Omega-3 Polyunsaturated Fatty Acids in the Treatment of Patients with IgA Nephropathy? Clin. J. Am. Soc. Nephrol., September 1, 2006; 1(5): 933 - 939. [Abstract] [Full Text] [PDF]

				G. B. Appel To Treat or Not to Treat IgA Nephropathy? That Is the Question! Clin. J. Am. Soc. Nephrol., May 1, 2006; 1(3): 347 - 348. [Full Text] [PDF]

				R. J. Hogg, J. Lee, N. Nardelli, B. A. Julian, D. Cattran, B. Waldo, R. Wyatt, J. C. Jennette, R. Sibley, K. Hyland, et al. Clinical Trial to Evaluate Omega-3 Fatty Acids and Alternate Day Prednisone in Patients with IgA Nephropathy: Report from the Southwest Pediatric Nephrology Study Group Clin. J. Am. Soc. Nephrol., May 1, 2006; 1(3): 467 - 474. [Abstract] [Full Text] [PDF]

				G. Frisch, J. Lin, J. Rosenstock, G. Markowitz, V. D'Agati, J. Radhakrishnan, D. Preddie, J. Crew, A. Valeri, and G. Appel Mycophenolate mofetil (MMF) vs placebo in patients with moderately advanced IgA nephropathy: a double-blind randomized controlled trial Nephrol. Dial. Transplant., October 1, 2005; 20(10): 2139 - 2145. [Abstract] [Full Text] [PDF]

				R. Oh Practical Applications of Fish Oil ({Omega}-3 Fatty Acids) in Primary Care J Am Board Fam Med, January 1, 2005; 18(1): 28 - 36. [Abstract] [Full Text] [PDF]

				M. Laville and E. Alamartine Treatment options for IgA nephropathy in adults: a proposal for evidence-based strategy Nephrol. Dial. Transplant., August 1, 2004; 19(8): 1947 - 1951. [Full Text] [PDF]

				C. C. Geddes, V. Rauta, C. Gronhagen-Riska, L. P. Bartosik, A. G. Jardine, L. S. Ibels, Y. Pei, and D. C. Cattran A tricontinental view of IgA nephropathy Nephrol. Dial. Transplant., August 1, 2003; 18(8): 1541 - 1548. [Abstract] [Full Text] [PDF]

				C. C. Geddes, V. Rauta, C. Gronhagen-Riska, L. P. Bartosik, A. G. Jardine, L. S. Ibels, Y. Pei, and D. C. Cattran A tricontinental view of IgA nephropathy Nephrol. Dial. Transplant., August 1, 2003; 18(88): 1541 - 1548. [Abstract] [Full Text]

				J. V. Donadio and J. P. Grande IgA Nephropathy N. Engl. J. Med., September 5, 2002; 347(10): 738 - 748. [Full Text] [PDF]

				J. V. Donadio, E. J. Bergstralh, J. P. Grande, and D. M. Rademcher Proteinuria patterns and their association with subsequent end-stage renal disease in IgA nephropathy Nephrol. Dial. Transplant., July 1, 2002; 17(7): 1197 - 1203. [Abstract] [Full Text] [PDF]

				D. Hernandez, R. Guerra, A. Milena, A. Torres, S. Garcia, C. Garcia, P. Abreu, A. Gonzalez, M. A. Gomez, M. Rufino, et al. Dietary fish oil does not influence acute rejection rate and graft survival after renal transplantation: a randomized placebo-controlled study Nephrol. Dial. Transplant., May 1, 2002; 17(5): 897 - 904. [Abstract] [Full Text] [PDF]

				J. J. Pestka, H.-R. Zhou, Q. Jia, and A. M. Timmer Dietary Fish Oil Suppresses Experimental Immunoglobulin A Nephropathy in Mice J. Nutr., February 1, 2002; 132(2): 261 - 269. [Abstract] [Full Text] [PDF]

				F. W. Ballardie and I. S. D. Roberts Controlled Prospective Trial of Prednisolone and Cytotoxics in Progressive IgA Nephropathy J. Am. Soc. Nephrol., January 1, 2002; 13(1): 142 - 148. [Abstract] [Full Text] [PDF]

				J. V. DONADIO JR., T. S. LARSON, E. J. BERGSTRALH, and J. P. GRANDE A Randomized Trial of High-Dose Compared with Low-Dose Omega-3 Fatty Acids in Severe IgA Nephropathy J. Am. Soc. Nephrol., April 1, 2001; 12(4): 791 - 799. [Abstract] [Full Text] [PDF]

				J. J. DILLON Treating IgA Nephropathy J. Am. Soc. Nephrol., April 1, 2001; 12(4): 846 - 847. [Full Text] [PDF]

				L. Butani and J. Palmer Effect of fish oil in a patient with post-transplantation IgA nephropathy Nephrol. Dial. Transplant., August 1, 2000; 15(8): 1264 - 1265. [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673