EFFECT OF 3 SOURCES OF LONG-CHAIN FATTY-ACIDS ON THE PLASMA FATTY-ACID PROFILE, PLASMA PROSTAGLANDIN E(2) CONCENTRATIONS, AND PRURITUS SYMPTOMS IN HEMODIALYSIS-PATIENTS

Patients with chronic renal failure exhibit plasma fatty acid patterns indicative of essential fatty acid deficiency. The plasma fatty acid profile of 25 hemodialysis patients with a history of pruritus symptom s indicated lower 20:3n-9 (eicosatrienoic acid), 20:4n-6 (arachidonic acid), and 20:5n-3 (eicosapentaenoic acid) concentrations; a higher 18 :1n-9 (oleic acid) concentration; and above-normal ranges of prostagla ndin E(2) (PGE(2)) compared with 22 subjects chosen from a normal popu lation. No significant difference in 22:6n-3 (docosahexaenoic acid) wa s shown between the hemodialysis patients and the normal subjects. The dietary intake of 20:5n-3 was higher and that of ls:1n-9 lower in the patients compared with the normal population group. In this 8-wk doub le-blind study the hemodialysis patients were randomly assigned to rec eive daily supplements of 6 g ethyl eater of either fish oil, olive oi l, or safflower oil. At the end of 8 wk of treatment the fish oil grou p (FO group) had a greater decrease in 18:1n-9 (P < 0.05), greater inc reases in 20:5n-3 and 22:6n-3 (P < 0.01), and trends toward a greater decrease in 20:4n-6, a greater increase in PGE, concentrations, and gr eater improvement in pruritus scores (0.10 > P > 0.05) compared with t he other two groups. The increases in 20:5n-3 and 22:6n-3 in the FO gr oup indicate compliance with fish oil supplementation. Results indicat e that hemodialysis patients have abnormal fatty acid profiles and inc reased PGE, values. Fish oil intervention changes the fatty acid profi le and may improve the symptoms of pruritus.