N-3 POLYUNSATURATED FATTY-ACID SUPPLEMENTATION IN CHRONIC PROGRESSIVERENAL-DISEASE

Chronic renal failure (CRF) may be accelerated by secondary lipid and immune abnormalities which could be antagonized by polyunsaturated fat ty acid (PUFA), We examined 20 CRF patients on conservative treatment, randomized in two groups: G1 consisted of 10 control patients and G2 10 patients supplemented for 12 months with a 3.4 g daily dose of PUFA , In basal conditions and after 12 months the following parameters wer e checked: creatinine clearance (CCr), daily urinary protein excretion per unit of residual renal function (UProt/CCr), rate of progression of renal insufficiency (Delta CCr); triglycerides (TG), total(TC), HDL (HDALC) and LDL (LDLC) cholesterol, apolipoproteins Apo Al, Apo B, li poprotein(a) Lp(a); lymphocyte subpopulations; spontaneous (c) and sti mulated (s) cytokines IL-1 beta, IL-2, tumor necrosis factors TNF-alph a secretion by peripheral mononuclear cells, The groups did not differ in their basal parameters, which did not change in G1 during follow-u p, In G2 the following parameters, initially higher than normal signif icantly decreased after 12 months: TG (2.9 +/- 0.45 to 2.6 +/- 0.3 mmo l/l p<0.005), Apo B (1.40 +/- 0.37 to 1.22 +/- 0.36 g/l, p<0.05), c TN F-alpha (1008.1 +/- 534.9 to 726.8 +/- 458.7 pg/ml, p<0.05), Spontaneo us (c) IL-1 beta (216.7 +/- 116.2 to 150.5 +/- 107.8 pg/ml, p<0.05), c IL-2 (124.5 +/- 43.8 to 101.6 +/- 25.8 pg/ml, p<0.05), and s TNF-alph a (2456.4 +/- 908.3 to 1632.2 +/- 497.1 pg/ml, p<0.005) also decreased , although already within the normal range at baseline, G2 patiens exp erienced a steady monthly reduction of CCr whereas it rose progressive ly in G1 (p<0.05), with a simultaneous increase In UProt/CCr (p<0.05). PUFA are beneficial on the lipid and immune abnormalities secondary t o CRF and may also have a useful effect on the progression of chronic renal damage.