A randomized controlled trial of the effects of n-3 fatty acids on resolvins in chronic kidney disease

Clin Nutr. 2016 Apr;35(2):331-336. doi: 10.1016/j.clnu.2015.04.004. Epub 2015 Apr 13.


Background and objective: The high incidence of cardiovascular disease (CVD) in chronic kidney disease (CKD) is related partially to chronic inflammation. n-3 Fatty acids have been shown to have anti-inflammatory effects and to reduce the risk of CVD. Specialized Proresolving Lipid Mediators (SPMs) derived from the n-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) actively promote the resolution of inflammation. This study evaluates the effects of n-3 fatty acid supplementation on plasma SPMs in patients with CKD.

Methods: In a double-blind, placebo-controlled intervention of factorial design, 85 patients were randomized to either n-3 fatty acids (4 g), Coenzyme Q10 (CoQ) (200 mg), both supplements, or control (4 g olive oil), daily for 8 weeks. The SPMs 18-HEPE, 17-HDHA, RvD1, 17R-RvD1, and RvD2, were measured in plasma by liquid chromatography-tandem mass spectrometry before and after intervention.

Results: Seventy four patients completed the 8 weeks intervention. n-3 Fatty acids but not CoQ significantly increased (P < 0.0001) plasma levels of 18-HEPE and 17-HDHA, the upstream precursors to the E- and D-series resolvins, respectively. RvD1 was significantly increased (P = 0.036) after n-3 fatty acids, but no change was seen in other SPMs. In regression analysis the increase in 18-HEPE and 17-HDHA after n-3 fatty acids was significantly predicted by the change in platelet EPA and DHA, respectively.

Conclusion: SPMs are increased after 8 weeks n-3 fatty acid supplementation in patients with CKD. This may have important implications for limiting ongoing low grade inflammation in CKD.

Keywords: Fish oil; Inflammation resolution; Renal disease; Resolvins.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Anti-Inflammatory Agents, Non-Steroidal / blood
  • Blood Glucose / metabolism
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Dietary Supplements
  • Docosahexaenoic Acids / administration & dosage*
  • Docosahexaenoic Acids / blood
  • Double-Blind Method
  • Eicosapentaenoic Acid / administration & dosage*
  • Eicosapentaenoic Acid / blood
  • Female
  • Humans
  • Hydroxyeicosatetraenoic Acids / blood
  • Inflammation / drug therapy
  • Insulin / blood
  • Male
  • Middle Aged
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / drug therapy


  • Anti-Inflammatory Agents, Non-Steroidal
  • Blood Glucose
  • Hydroxyeicosatetraenoic Acids
  • Insulin
  • resolvin D1
  • resolvin D2
  • 18-hydroxy-5,8,11,14-eicosatetraenoic acid
  • Docosahexaenoic Acids
  • C-Reactive Protein
  • 17-hydroxy-4,7,10,13,15,19-docosahexaenoic acid
  • Eicosapentaenoic Acid