Nephrol Dial Transplant (2002) 17: 897-904
© 2002 European Renal Association-European Dialysis and Transplant Association
Dietary fish oil does not influence acute rejection rate and graft survival after renal transplantation: a randomized placebo-controlled study
1 Nephrology Section, 2 Research Unit, 3 Biochemical Section and 4 Service of Nuclear Medicine, University Hospital of the Canary Islands, La Laguna, Tenerife, Spain
Background. Dietary fish oil, rich in omega-3 polyunsaturated fatty acids, decreases TNF-
, IL-1ß and IL-2 levels, which may benefit renal transplant recipients. To explore this possibility, we studied the effect of fish oil on the incidence of acute rejection, in situ expression of interleukins (TNF-, IL-1ß and IL-2) and renal function after renal transplantation.
Methods. In a double-blind clinical trial, 86 subjects with no immunological risk randomly received either 6 g/day of fish oil (fish oil group; n=46) or soy oil (control group; n=40) during the first 3 months after transplantation. The mRNA expression of interleukins (TNF-, IL-1ß and IL-2) was determined by RT-PCR using fine-needle aspiration during follow-up (at baseline and the 1st, 2nd and 3rd month after renal transplantation), as well as during acute rejection episodes and after anti-rejection therapy. The glomerular filtration rate was determined at baseline, and at 1 and 3 months post-graft by [51Cr]EDTA clearances.
Results. The incidence of acute rejection during the first post-transplant year was similar in both groups (44 vs 47%), as was 1-year graft survival (86 vs 89%). There were no differences between groups in overall renal expression of interleukins in patients who did not suffer rejections during the study. At rejection episodes, the fish oil group showed a trend toward a lower renal expression of TNF- (3.7±6.8 vs 15±18.6 TNF-/actin, ratio of arbitrary optical units; P=0.05). In addition, a trend toward a lower IL-1ß expression after therapy was observed in the fish oil group (49.3±54 vs 84.4±59 IL-1ß/actin, ratio of arbitrary optical units; P=0.05). However, the severity of acute rejections (Banff criteria) as well as renal function after anti-rejection treatment were similar in both groups. Finally, a greater reduction in triglyceride levels was observed in the fish oil group compared with the control group (-6.6±52.7 vs 12.7±40.2%; P<0.05).
Conclusions. Treatment with fish oil during the first 3 months post-transplantation does not influence acute rejection rate and has no beneficial effect on renal function or graft survival.
Keywords: cytokines; fine needle aspiration; kidney transplantation; omega-3 polyunsaturated fatty acids
Correspondence and offprint requests to: Domingo Hernández, Urbanización San Diego, 51, 38208 La Laguna, Tenerife, Canary Islands, Spain. Email: dhmarrero{at}hotmail.com
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  A. Tatsioni, M. Chung, Y. Sun, B. Kupelnick, A. H. Lichtenstein, R. Perrone, P. Chew, J. Lau, and P. A. Bonis Effects of Fish Oil Supplementation on Kidney Transplantation: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials J. Am. Soc. Nephrol., August 1, 2005; 16(8): 2462 - 2470. [Abstract] [Full Text] [PDF]
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