One of the first questions often asked by newly diagnosed kidney patients pertains to fish oil. While the jury is still out on whether the omega-3 fatty acids in fish oil provide long-term benefit for kidney patients, as of 2011, more and more nephrologists are suggesting that their patients begin a fish oil regimen.
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The term "kidney failure" or "renal failure" can be used to describe patients with slight renal scarring as well as patients on dialysis who have no kidney function left. Some people think the term "chronic renal insufficiency" better describes patients in the early stages of kidney disease.
The 1999 publication of James Donadio's paper on the long-term use of fish oil by patients with IgA nephropathy provided hope to kidney patients because it showed that high-dose fish oil supplementation slowed the progression of IgA nephropathy. Subjects in Donadio's study at the Mayo Clinic were followed for an average of 6.4 years. The kidneys of 85 percent of patients taking fish oil were projected to be functioning eight years after the beginning of the study. This eight-year renal survival estimate compares favorably with the 56 percent projected renal survival rate for controls. Donadio's research was the first credible evidence that the progression of this disease could be offset with a nutritional supplement.
Not all fish oil products are created equal. The active omega-3 fatty acids in fish oil are eicosapentanoic acid and docosahexanoic acid, also known as EPA and DHA. Donadio's subjects took enough enough fish oil to provide 1.9 g of EPA and 1.4 g of DHA. While most brands contain a gram of fish oil per capsule, the amount of DHA and EPA per capsule varies widely. Also check the serving size on this product. Brands claiming to have 1,200 mg of fish oil should be scrutinized closely because this 1,200 mg is found in a two-capsule serving, rather than a single capsule.
Although studies on fish oil supplementation in lupus and transplant patients have been conducted, the results are inconsistent. Writing in the October 2010 issue of the "American Journal of Kidney Disease," R. G. Fassett notes that "the role of omega-3 polyunsaturated fatty acids in the treatment of kidney disease remains unclear." More long-term studies and controlled clinical trials are needed.
Talk to your nephrologist before taking fish oil, especially if you take daily aspirin, ibuprofen or other non-steroid anti-inflammatory drugs because fish oil can enhance the anti-platelet action of these drugs. This is a particular concern for patients who take aspirin every day to prevent heart disease.