Is body size a biomarker for optimizing dosing of omega-3 polyunsaturated fatty acids in the treatment of patients with IgA nephropathy?

Abstract

Re-analysis of the North American IgA Nephropathy Study suggested that efficacy of omega-3 polyunsaturated fatty acids (omega-3 PUFA) was dosage-dependent on the basis of body size and plasma omega-3/omega-6 and eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratios. The objective of this study was to confirm these assertions. Data from a previously reported randomized 2-yr clinical trial in which two dosages of an ethyl ester omega-3 PUFA (Omacor) were given to 73 high-risk patients with IgA nephropathy were reviewed. Omacor also was used in the North American IgA Nephropathy Study. Parameters included body weight; body mass index (BMI); plasma phospholipid AA, EPA, and docosahexanoic acid (DHA) levels and serum creatinine and 24-h urine protein (UP) levels during the 2-yr trial; and time to ESRD after 6.4 yr. Plasma phospholipid levels of EPA, DHA, and EPA/AA ratios were significantly inversely correlated with increasing body weight and BMI in the Omacor 4-g dosage group but not in the Omacor 8-g dosage group. Conversely, increasing levels of lipid parameters were observed with increasing dosages of Omacor (EPA+DHA) in grams per kilogram of body weight at 6 wk of treatment. None of the plasma omega-3 PUFA levels, EPA/AA ratios, or Omacor dosage per kilogram was significantly associated with reciprocal serum creatinine or UP slopes during the 2-yr trial or with ESRD. This post hoc analysis of body weight and BMI, plasma omega-3 PUFA status, and renal outcome did not find that treatment efficacy of omega-3 PUFA was dosage dependent on the basis of body size.

• Authors: James V Donadio, Eric J Bergstralh, Douglas M Bibus, Joseph P Grande
• Journal: Clinical journal of the American Society of Nephrology : CJASN (Clin J Am Soc Nephrol) Vol. 1 Issue 5 Pg. 933-9 (Sep 2006) ISSN: 1555-905X [Electronic] United States
• PMID: 17699310 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Drug Combinations
• Phospholipids
• Docosahexaenoic Acids
• Arachidonic Acid
• Eicosapentaenoic Acid
• Creatinine
• Omacor

Topics

• Arachidonic Acid (blood)
• Body Mass Index
• Body Size
• Body Weight
• Creatinine (blood)
• Disease Progression
• Docosahexaenoic Acids (administration & dosage, blood)
• Dose-Response Relationship, Drug
• Drug Combinations
• Eicosapentaenoic Acid (administration & dosage, blood)
• Glomerulonephritis, IGA (blood, complications, drug therapy, physiopathology)
• Humans
• Kaplan-Meier Estimate
• Kidney Failure, Chronic (blood, etiology, physiopathology)
• Phospholipids (blood)
• Proportional Hazards Models
• Proteinuria (blood, drug therapy, etiology, physiopathology)
• Risk Assessment
• Time Factors
• Treatment Outcome