EFFECT OF DIETARY FISH-OIL ON RENAL-FUNCTION AND REJECTION IN CYCLOSPORINE-TREATED RECIPIENTS OF RENAL-TRANSPLANTS

Background. Dietary fish oil exerts effects on renal hemodynamics and the immune response that may benefit renal-transplant recipients treat ed with cyclosporine. To evaluate this possibility, we studied the eff ect of fish oil on renal function, blood pressure, and the incidence o f acute rejection episodes in cyclosporine-treated recipients of renal transplants. Methods. In a randomized, double-blind trial, 33 recipie nts of first cadaveric kidney transplants who were treated with cyclos porine and prednisolone ingested 6 g of fish oil daily during the firs t postoperative year (the fish-oil group), whereas another 33 renal-gr aft recipients treated with cyclosporine and prednisolone ingested 6 g of coconut oil daily for three months, after which time it was stoppe d (the control group). Results. One year after transplantation, the fi sh-oil group had higher median values than the controls for glomerular filtration rate (53 vs. 40 ml per minute per 1.73 m2, P = 0.038) and effective renal plasma flow (214 vs. 178 ml per minute per 1.73 m2, P = 0.023) and lower mean arterial pressure (103 vs. 118 mm Hg, P = 0.00 11). The cyclosporine doses in the two groups were similar. The cumula tive number of rejection episodes was 20 in the controls, as compared with 8 in the fish-oil group (P = 0.029). One-year graft survival also tended to be better in the fish-oil group (97 vs. 84 percent, P = 0.0 97). Conclusions. The daily administration of 6 g of fish oil during t he first postoperative year has a beneficial effect on renal hemodynam ics and blood pressure in renal-transplant recipients treated with cyc losporine. Although the fish-oil group had significantly fewer rejecti on episodes than the control group, graft survival at one year was not significantly better in the fish-oil group.