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Effects of Fish Oil Supplementation on Kidney Transplantation: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials

Athina Tatsioni^*, Mei Chung^*, Yannan Sun^*, Bruce Kupelnick^*, Alice H. Lichtenstein, Ronald Perrone, Priscilla Chew^*, Joseph Lau^* and Peter A. Bonis

^* Institute for Clinical Research and Health Policy Studies, Tufts-NEMC Evidence-Based Practice Center; Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging; Division of Nephrology; and Division of Gastroenterology, Tufts-New England Medical Center, Boston, Massachusetts

Address correspondence to: Dr. Joseph Lau, Tufts-New England Medical Center, Evidence-Based Practice Center, Institute for Clinical Research and Health Policy Studies, 750 Washington Street, Box 63, Boston, MA 02111. Phone: 617-636-7670; Fax: 617-636-8628; jlau1{at}tufts-nemc.org

Received for publication February 16, 2005. Accepted for publication May 4, 2005.

The objective of this study was to assess the effects of omega-3 fatty acid supplementation on various kidney transplant–related outcomes. A systematic review and meta-analysis was performed of published randomized, controlled trials (RCT). There were 16 kidney transplant RCT with a total of 812 patients. All trials evaluated fish oil with dosages that ranged from 1.2 to 5.4 g/d. No consistent benefits were observed for any outcome with the exception of a modest benefit on triglycerides. A meta-analysis of rejection episodes found no significant benefit on either early (<6 mo posttransplantation) or late episodes. The overall relative risk of having at least one rejection episode in those who received fish oil was 0.91 (95% confidence interval 0.74 to 1.10) in four studies with a follow-up of 1 yr. A meta-analysis of eight RCT of graft survival found no significant benefit (relative risk 1.00, 95% confidence interval 0.96 to 1.05). The available data (mostly derived from older studies with important methodologic limitations) do not demonstrate a consistent, clinically important benefit of fish oil in kidney transplantation.

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