(01-03-14) The role of fish oil/omega-3 fatty acids in the treatment of IgA nephropathy.

Donadio JV, Grande JP.

Author information Division of Nephrology, the Department of Medicine, and the
Department of Laboratory Medicine and Pathology, Mayo Clinic & Mayo Foundation,
Rochester, MN, USA. [email protected]
Abstract
Beneficial effects of omega-3 polyunsaturated fatty acids (n-3 PUFA) have been
reported in recent epidemiologic studies and randomized clinical trials in a
variety of cardiovascular and autoimmune diseases. Fish and marine oils are the
most abundant and convenient sources of eicosapentaenoic acid (EPA) and
docosahexaenoic acid (DHA), the two major n-3 fatty acids that serve as
substrates for cyclooxygenase and lipoxygenase pathways leading to less potent
inflammatory mediators than those produced through the n-6 PUFA substrate,
arachidonic acid. N-3 PUFA can also suppress inflammatory and/or immunologic
responses through eicosanoid-independent mechanisms. Although the
pathophysiology of IgA nephropathy is incompletely understood, it is likely
that n-3 PUFA prevents renal disease progression by interfering with a number
of effector pathways triggered by mesangial immune-complex deposition. In
addition, potential targets of n-3 PUFA relevant to renal disease progression
could be similar to those involved in preventing the development and
progression of cardiovascular disease by lowering blood pressure, reducing
serum lipid levels, decreasing vascular resistance, or preventing thrombosis.
In IgA nephropathy, efficacy of n-3 PUFA contained in fish oil supplements has
been tested with varying results. The largest randomized clinical trial
performed by our collaborative group provided strong evidence that treatment
for 2 years with a daily dose of 1.8 g of EPA and 1.2 g of DHA slowed the
progression of renal disease in high-risk patients. These benefits persisted
after 6.4 years of follow up. With safety, composition, and dosing convenience
in mind, we can recommend two products that are available as pharmaceutical-
grade fish-oil concentrates, Omacor (Pronova Biocare, Oslo, Norway) and
Coromega (European Reference Botanical Laboratories, Carlsbad, CA).

Source: Semin Nephrol. 2004 May;24(3):225-43.

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