The association between marine n-3 polyunsaturated fatty acid levels and survival after renal transplantation

Abstract

Background and objectives Several studies have reported beneficial cardiovascular effects of marine n-3 polyunsaturated fatty acids. To date, no large studies have investigated the potential benefits of marine n-3 polyunsaturated fatty acids in recipients of renal transplants. Design, setting, participants, &measurements In this observational cohort study of 1990 Norwegian recipients of renal transplants transplanted between 1999 and 2011, associations between marine n-3 polyunsaturated fatty acid levels and mortality were investigated by stratified analysis and multivariable Cox proportional hazard regression analysis adjusting for traditional and transplant-specific mortality risk factors. Marine n-3 polyunsaturated fatty acid levels in plasma phospholipids were measured by gas chromatography in a stable phase 10 weeks after transplantation. Results There were 406 deaths (20.4%) during a median follow-up period of 6.8 years. Mortality rates were lower in patients with high marine n-3 polyunsaturated fatty acid levels (≥7.95 weight percentage) compared with low levels (<7.95 weight percentage) for all age categories (pooledmortality rate ratio estimate, 0.69; 95%confidence interval, 0.57 to 0.85).Whendivided into quartiles according to marine n-3polyunsaturated fatty acid levels, patients in the upper quartile comparedwith the lower quartile had a 56%lower risk of death (adjustedhazard ratio, 0.44; 95%confidence interval, 0.26 to 0.75) using multivariable Cox proportional hazard regression analysis. Therewas a lower hazard ratio for death from cardiovascular diseasewith high levels ofmarine n-3 polyunsaturated fatty acid and a lower hazard ratio for death from infectious diseasewith high levels of the marine n-3 polyunsaturated fatty acid eicosapentaenoic acid,whereas therewas no association between total or individual marine n-3 polyunsaturated fatty acid levels and cancer mortality. Conclusions Higher plasma phospholipid marine n-3 polyunsaturated fatty acid levels were independently associated with better patient survival.