Document Detail


Fish oil treatment for kidney transplant recipients: a meta-analysis of randomized controlled trials.
MedLine Citation:
PMID:  17460552     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Calcineurin inhibitors have adverse effects that contribute to nephrotoxicity and cardiovascular risk profile, and these may be reduced by administration of fish oil. The aim of this review was to assess the benefits and harms of fish oil supplementation in kidney transplant recipients on a calcineurin inhibitor-based immunosuppressive regimen. METHODS: The Cochrane Controlled Trials Registry, MEDLINE, and EMBASE were searched for randomized controlled trials of fish oil treatment in kidney transplant recipients on a calcineurin inhibitor-based immunosuppressive regimen. Trials comparing fish oil to both placebo and statins were included. Data were extracted for patient and graft survival, acute rejection, calcineurin inhibitor toxicity, cardiovascular events, adverse effects, compliance, renal function, blood pressure, and lipid profile. Dichotomous outcomes were reported as relative risk and continuous outcome measures as weighted mean differences (WMD), with 95% confidence intervals. RESULTS: Sixteen suitable trials were analyzed. Fish oil treatment was associated with a lower diastolic blood pressure (WMD 4.5 mmHg, P=0.004) and higher high-density lipoprotein (HDL) cholesterol (WMD 0.12 mmol/L, P=0.01) but did not affect the other outcomes. Fishy aftertaste and gastrointestinal upset were common but did not result in significant dropout. Fish oil effects on lipids were not significantly different than low-dose statins. CONCLUSION: There is insufficient evidence from currently available randomized controlled trials to recommend fish oil therapy to improve renal function, rejection rates, and patient or graft survival. Improvements in HDL cholesterol and diastolic blood pressure were too modest to recommend routine use.
Authors:
Andy K H Lim; Karen J Manley; Matthew A Roberts; Margaret B Fraenkel
Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Transplantation     Volume:  83     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-26     Completed Date:  2007-08-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  831-8     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Monash Medical Centre, Clayton, Victoria, Australia. andy.lim@med.monash.edu.au
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MeSH Terms
Descriptor/Qualifier:
Cadaver
Fish Oils / therapeutic use*
Graft Survival
Humans
Kidney Transplantation / physiology*,  standards,  statistics & numerical data
Living Donors
Randomized Controlled Trials as Topic
Registries
Research Design
Tissue Donors
Chemical
Reg. No./Substance:
0/Fish Oils

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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