The omega-3
polyunsaturated fatty acids in
fish oil have been shown to produce beneficial effects, such as a reduction in blood pressure,
proteinuria,
lipid levels and
inflammation. Aggregated
immunoglobulin A obtained from
IgA nephropathy patients induced greater
oxygen free radicals in polymorphonuclear leukocytes than other glomerulopathy. All of which may affect the course of
IgA nephropathy. Twenty-three adult patients with biopsy proven
IgA nephropathy, with
proteinuria more than 1 g/day, serum
creatinine less than 3 mg/dl and blood pressure control less than 130/80 mmHg were given omega-3
polyunsaturated fatty acids (PUFA) in the form of an
Omacor capsule 4 g/day equivalent to
eicosapentaenoic acid (EPA) 1.88 g and
docosahexaenoic acid (DHA) 1.48 g for 6 months. A 3 to 6 month follow-up was planned, with monthly evaluations of the patients. By six months, the serum
triglyceride was significantly reduced (143.45 +/- 62.65 vs 91 +/- 42.89 mg/dl, p = 0.002), serum
cholesterol was also reduced but not statistically significant (234.16 +/- 56.29 vs 219.76 +/- 51.25 mg/dl, p = 0.07). There was a trend of increased serum
high density lipoprotein (
HDL)-cholesterol (39.26 +/- 10.56 vs 42.72 +/- 8.37 mg/dl, p = 0.056). Urine beta-2-microglobulin was elevated in
IgA patients and decreased statistically significant after 3 months (453 +/- 580 vs 308 +/- 274 microg/24 h, p < 0.001) and 6 months of
fish oil therapy (453 +/- 580 vs 142 +/- 182, p < 0.03) while urine N-acetyl-
glucosaminidase (NAG) was of no significant difference both before and after
fish oil administration (21 +/- 10 vs 22 +/- 10 and 21 +/- 9 U/24 h, p = 0.08). Plasma
malondialdehyde (MDA), the end product of oxidative stress was statistically, significantly decreased (1.09 +/- 0.51 vs 0.89 +/- 0.49 nmol/L, p = 0.003). The study did not show any change in blood pressure,
proteinuria, or serum
creatinine. The authors conclude from the results of this study that patients with idiopathic
IgA nephropathy with
proteinuria and mildly reduced GFR did not benefit from short-term treatment with 4 g per day of omega-3 PUFA regarding the total
protein excretion and glomerular filtration rate (GFR), but the advantage was the improvement in tubular dysfunction,
lipid profiles, and oxidative stress.