Effectiveness of Omega-3 Fatty Acid Supplementation for Pruritus in Patients Undergoing Hemodialysis

Overview

Journal Front Nutr

Specialty Nutritional Sciences

Date 2024 Feb 13

PMID 38347960

Authors

Alireza Rafieipoor

Mahdie Torkaman

Fatemeh Azaryan

Aryan Tavakoli

Mohammad Keshavarz Mohammadian

Atefeh Kohansal

Hanieh Shafaei

Pouya Mirzaee

Zeinab Motiee Bijarpasi

Parsa Bahmani

Masoud Khosravi

Saeid Doaei

Maryam Gholamalizadeh

Affiliations

Soon will be listed here.

Abstract

Background: Patients undergoing hemodialysis (HD) frequently experience the chronic kidney disease-associated pruritus (CKD-aP).

Objective: The aim of this study was to investigate the effectiveness of omega-3 supplementation in the management of CKD-aP in patients undergoing hemodialysis.

Methods: In this triple blind, randomized clinical trial, the effect of the omega-3 supplement on uremic CKD-aP was assessed in 112 chronic hemodialysis patients at Caspian Hemodialysis Center in Rasht, Iran. Patients were randomly divided into the intervention group receiving omega-3 supplements (3 g/day) and the control group receiving placebo containing MCT oil for 2 months.

Results: Omega-3 supplementation had no effect on CKD-aP. The results did not change after adjusting for age and sex, additional adjustments for weight, height, physical activity, smoking, and alcohol use, additional adjustments for underlying diseases and weight, height, physical activity, smoking, and drinking alcohol, and further adjustments for underlying diseases and biochemical indices.

Discussion: Omega-3 supplementation for 2 months had no effect on CKD-aP in patients with CKD. Further studies with longer duration are warranted.

Clinical Trial Registration: https://www.irct.ir/trial/66638, IRCT20151226025699N6.

Citing Articles

Efficacy and Safety of Omega-3 Fatty Acids in Ameliorating Pruritus in Adult Patients With Chronic Kidney Disease: A Meta-Analysis of Randomized Controlled Trials.

Alqahtani S, Bakhamees B, Almalki F, Alshaer A, Altaymani A, Alazmi M Cureus. 2024; 16(8):e66452.

PMID: 39246955 PMC: 11380528. DOI: 10.7759/cureus.66452.

References

Sepehri N, Parvizi M, Habibzadeh S, Handjani F . Lettuce as an Effective Remedy in Uremic Pruritus: Review of the Literature Supplemented by an In Silico Study. Evid Based Complement Alternat Med. 2022; 2022:4231854. PMC: 8983187. DOI: 10.1155/2022/4231854. View

Friedman A, Moe S . Review of the effects of omega-3 supplementation in dialysis patients. Clin J Am Soc Nephrol. 2007; 1(2):182-92. DOI: 10.2215/CJN.00740805. View

Sukul N, Karaboyas A, Csomor P, Schaufler T, Wen W, Menzaghi F . Self-reported Pruritus and Clinical, Dialysis-Related, and Patient-Reported Outcomes in Hemodialysis Patients. Kidney Med. 2021; 3(1):42-53.e1. PMC: 7873756. DOI: 10.1016/j.xkme.2020.08.011. View

Cheng A, Wong L . Uremic Pruritus: From Diagnosis to Treatment. Diagnostics (Basel). 2022; 12(5). PMC: 9140050. DOI: 10.3390/diagnostics12051108. View

Elhag S, Rivas N, Tejovath S, Mustaffa N, Deonarine N, Abdullah Hashmi M . Chronic Kidney Disease-Associated Pruritus: A Glance at Novel and Lesser-Known Treatments. Cureus. 2022; 14(1):e21127. PMC: 8752116. DOI: 10.7759/cureus.21127. View

Ghanei E, Zeinali J, Borghei M, Homayouni M . Efficacy of omega-3 fatty acids supplementation in treatment of uremic pruritus in hemodialysis patients: a double-blind randomized controlled trial. Iran Red Crescent Med J. 2012; 14(9):515-22. PMC: 3482323. View

Rayner H, Larkina M, Wang M, Graham-Brown M, van der Veer S, Ecder T . International Comparisons of Prevalence, Awareness, and Treatment of Pruritus in People on Hemodialysis. Clin J Am Soc Nephrol. 2017; 12(12):2000-2007. PMC: 5718267. DOI: 10.2215/CJN.03280317. View

Tur J, Bibiloni M, Sureda A, Pons A . Dietary sources of omega 3 fatty acids: public health risks and benefits. Br J Nutr. 2012; 107 Suppl 2:S23-52. DOI: 10.1017/S0007114512001456. View

Begum R, Belury M, Burgess J, Peck L . Supplementation with n-3 and n-6 polyunsaturated fatty acids: effects on lipoxygenase activity and clinical symptoms of pruritus in hemodialysis patients. J Ren Nutr. 2004; 14(4):233-41. View

10.

Pisoni R, Wikstrom B, Elder S, Akizawa T, Asano Y, Keen M . Pruritus in haemodialysis patients: International results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant. 2006; 21(12):3495-505. DOI: 10.1093/ndt/gfl461. View

11.

Kim D, Pollock C . Epidemiology and burden of chronic kidney disease-associated pruritus. Clin Kidney J. 2022; 14(Suppl 3):i1-i7. PMC: 8702817. DOI: 10.1093/ckj/sfab142. View

12.

Davidson M, Kling D, Maki K . Novel developments in omega-3 fatty acid-based strategies. Curr Opin Lipidol. 2011; 22(6):437-44. DOI: 10.1097/MOL.0b013e32834bd642. View

13.

Ponticelli C, Bencini P . Pruritus in dialysis patients: a neglected problem. Nephrol Dial Transplant. 1995; 10(12):2174-6. DOI: 10.1093/ndt/10.12.2174. View

14.

Visioli F, Rise P, Barassi M, Marangoni F, Galli C . Dietary intake of fish vs. formulations leads to higher plasma concentrations of n-3 fatty acids. Lipids. 2003; 38(4):415-8. DOI: 10.1007/s11745-003-1077-x. View

15.

Narita I, Iguchi S, Omori K, Gejyo F . Uremic pruritus in chronic hemodialysis patients. J Nephrol. 2008; 21(2):161-5. View

16.

Zucker I, Yosipovitch G, David M, Gafter U, Boner G . Prevalence and characterization of uremic pruritus in patients undergoing hemodialysis: uremic pruritus is still a major problem for patients with end-stage renal disease. J Am Acad Dermatol. 2003; 49(5):842-6. DOI: 10.1016/s0190-9622(03)02478-2. View

17.

Simonsen E, Komenda P, Lerner B, Askin N, Bohm C, Shaw J . Treatment of Uremic Pruritus: A Systematic Review. Am J Kidney Dis. 2017; 70(5):638-655. DOI: 10.1053/j.ajkd.2017.05.018. View

18.

Kostoglou-Athanassiou I, Athanassiou L, Athanassiou P . The Effect of Omega-3 Fatty Acids on Rheumatoid Arthritis. Mediterr J Rheumatol. 2020; 31(2):190-194. PMC: 7362115. DOI: 10.31138/mjr.31.2.190. View

19.

Kuypers D . Skin problems in chronic kidney disease. Nat Clin Pract Nephrol. 2009; 5(3):157-70. DOI: 10.1038/ncpneph1040. View

20.

Vernon M, Swett L, Speck R, Munera C, Spencer R, Wen W . Psychometric validation and meaningful change thresholds of the Worst Itching Intensity Numerical Rating Scale for assessing itch in patients with chronic kidney disease-associated pruritus. J Patient Rep Outcomes. 2021; 5(1):134. PMC: 8709801. DOI: 10.1186/s41687-021-00404-z. View