OBJECTIVE - Recent studies in nondiabetic kidney diseases suggest that
dietary supplementation with n-3 polyunsaturated fatty acids (fish oi
l) may have beneficial effects on albuminuria, kidney function, arteri
al blood pressure, and dyslipidemia. Therefore, we evaluated the long-
term effect of fish oil in diabetic nephropathy. RESEARCH DESIGN END M
ETHODS - A 1-year double-blind randomized controlled study comparing f
ish oil (4.6 g n-3 fatty acids/day) with placebo (olive oil) was perfo
rmed in an outpatient clinic in a tertiary referral center. Thirty-six
normotensive IDDM patients with diabetic nephropathy were included; 1
8 were treated with fish oil. Seven patients dropped out (four receive
d fish oil), and results for the remaining 29 are presented. Albuminur
ia (enzyme immunoassay), glomemlar filtration rate (Cr-51-labeled EDTA
plasma clearance), 24-h ambulatory blood pressure, and lipid profile
were determined every 6 months. RESULTS - Albuminuria increased by 22%
(1-46%) (mean [95% CI]) in the fish oil group vs. 15% (-11-49%) in th
e placebo group (NS). Glomerular filtration rate decreased from 116 +/
-7 to 105 +/- 7 ml . min(-1) 1.73 m(-2) (mean +/- SE) vs. from 108 +/-
6 to 103 +/- 7, fish oil and placebo, respectively (NS). No significa
nt changes occurred in 24-h ambulatory blood pressure: from 141 +/- 4/
82 +/- 2 mmHg to 142 +/- 5/83 +/- 2 vs. from 140 +/- 4/78 +/- 2 to 144
+/- 4/80 +/- 3, fish oil and placebo, respectively (NS). In the fish
oil group, serum triglycerides (median [range]) decreased from 0.97 (0
.5-4.0) mmol/l to 0.8 (0.4-3.0) vs. from 1.01 (0.4-2.0) to 1.09 (0.4-2
.0) in the placebo group (P < 0.05) and VLDL cholesterol decreased fro
m 0.45 (0.23-1.88) to 0.37 (0.21-1.43) mmol/l vs. from 0.44 (0.21-0.94
) to 0.41 (0.17-1.94)(P < 0.05), but total and LDL cholesterol rose in
the fish oil compared with the placebo group. CONCLUSIONS - Our study
does not suggest that fish oil has beneficial effects on albuminuria,
kidney function, blood pressure, and dyslipidemia in normotensive IDD
M patients suffering from diabetic nephropathy.