The effect of ω-3 polyunsaturated fatty acids on hemorheological parameters of patients under chronic hemodialysis treatment

Abstract

In a pilot study, fifteen chronically hemodialysed patients with severe hypertriglyeridemia (>350 mg/dl) received polyunsaturated fatty acids corresponding to 1.26 g/day eicosapentaenoic acid and 0.9 g/day docosahexaenoic acid over a period of six months in addition to their normal diet. At the beginning and after 2, 4 and 6 months of fish oil administration, laboratory and hemorheological parameters were determined. Initially, all hemorheological and clinical chemical parameters relevant for lipid metabolism were increased. A decrease in plasma triglyceride, total cholesterol, LDL, VLDL and apoprotein A1 fractions together with an increase in HDL fraction were observed during the fish oil treatment. These significant changes were in well accordance with changes in hemorheological parameters. At the end of the study both the viscous and elastic components of complex viscoelasticity, aggregation index, flexibility index, and viscoelastic phase angle were significantly decreased, whereas the plasma viscosity, hematocrit and fibrinogen contents remained unchanged. Total protein and α₂-macroglobulin contents were also significantly reduced. Parallel measurements showed that during treatment the concentration of the applied ω-3 fatty acids in the red cell membrane increases significantly and that of arachidonic acid decreases. Thus the improvement in flow properties may result from adherence of fatty acids to the phospholipids of the red cell membrane, which leads to a reduction in membrane rigidity and aggregation tendency. It can therefore be concluded that long term low dose fish oil supplementation in hemodialysis patients reduces the increased lipid levels and improves the flow properties of blood into the normal range. Thus two risk factors concerning thrombosis and cardiovascular diseases can be positively influenced.