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Feasibility study of erythrocyte long-chain omega-3 polyunsaturated fatty acid content and mortality risk in hemodialysis patients.

OBJECTIVE
Long-chain omega-3 polyunsaturated fatty acids (n-3 PUFA) are increasingly believed to be cardioprotective. We tested the hypothesis that erythrocyte n-3 PUFA levels, as measured by the omega-3 index (O3I), are inversely related to mortality in hemodialysis patients.


DESIGN AND STUDY POPULATION
This was a retrospective study of 93 prevalent urban American hemodialysis patients with baseline n-3 PUFA blood levels.


MAIN OUTCOME MEASURE
The mortality rate was measured over a median period of 755 days.


RESULTS
The median omega-3 index was 4.69 mean weight %. During follow-up, 19 patients died, and 8 underwent renal transplantation. The probability of survival was significantly greater in patients with an O3I above the median (P = .025). Univariate analyses found that increasing age and a higher Charlson Comorbidity Index were associated with reduced survival, whereas a higher O3I and black race were linked with greater survival. In a multivariate model, only the Charlson Comorbidity Index score clearly predicted mortality (hazard ratio, 1.31; 95% confidence interval, 1.06 to 1.62), though a protective trend was observed with an O3I above the median (hazard ratio, 2.48; 95% confidence interval, 0.88 to 6.95).


CONCLUSION
Though this modest-sized study did not find a statistically significant relationship between erythrocyte n-3 PUFA levels and mortality, an inverse association was suggested. The existence of such a relationship will need to be confirmed in cohorts with greater statistical power.