SP751MARINE n-3 FATTY ACID SUPPLEMENTATION REDUCES INFLAMMATION & PREVENTS RENAL GRAFT FIBROSIS

Abstract

INTRODUCTION AND AIMS: Marine n‐3 fatty acids (FAs) possess anti‐inflammatory & possibly anti‐fibrotic properties that may halt progressive renal graft fibrosis & preserve renal function. METHODS: In this investigator initiated single center randomized double blind placebo controlled trial, 132 renal transplant recipients were randomized to receive daily either 2.6 g of marine n‐3 FAs or an equivalent dose of olive oil (controls) on top of standard care, which included all patients on triple immunosuppression & most patients on statin therapy (n=84). Patients were followed for 44 weeks (from baseline 8 weeks post‐transplant until one year after transplantation). Study measurements were performed at baseline & end of study, & included iohexol clearance (mGFR), C‐reactive protein (CRP), semi‐quantitative estimation of degree of interstitial fibrosis in graft biopsies & plasma phospholipid fatty acid composition. Results were expressed as change during follow‐up (D). RESULTS: Thirty patients withdrew from the study, many because of gastrointestinal side‐effects in both the marine n‐3 FA group (n=6) & control group (n=8). The cumulative incidence of adverse events did not differ between the marine n‐3 FA group (n=218) & controls (n=240). Compared with placebo, the marine n‐3 FA group had lower D CRP (intention‐to‐treat [ITT]:‐1.20610.98 mg/L vs 2.7±67.07 mg/L, p=0.02, per‐protocol [PP]:‐1.89611.64 mg/L vs 2.2767.42 mg/L, p=0.03), lower D percent graft fibrosis (PP:‐0.5768.96%vs 3.6±611.13 %, p=0.04) & a trend towards higher DmGFR (PP: 6.6±611.62 ml/min vs 4.33610.40 ml/min, p=0.29). Post hoc analyses showed that the degree of anti‐fibrotic effect was related to plasma phospholipid marine n‐3 FA levels (Figure 1). CONCLUSIONS: Marine FA supplementation was safe, reduced inflammation & prevented renal graft fibrosis (Figure presented).