Fish oil for dialysis patients

Fish oil for dialysis patients

A study in Kidney International 2013 has shown that kidney patients on dialysis with the highest levels of n–3 fatty acids have impressively low odds of sudden cardiac death, said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal President Heart Care Foundation of India and Dr Ramesh Hotchandani President IMA New Delhi Branch. 

Dialysis patients have dramatically low survival rates, between 35 and 45% at 5 years. Heart disease is responsible for 43% of deaths in this setting, and sudden cardiac death has now emerged as the leading single cause of mortality, accounting for approximately 25% of deaths. 

Sudden death is defined as an unexpected ‘natural’ death within a very short time period in a person without any prior condition that would appear fatal. 

Eighty percent of sudden deaths may be due to ventricular fibrillation. 

A variety of kidney– and dialysis–specific factors favor the occurrence of this complication, including left ventricular hypertrophy, heart failure, volume overload, myocardial fibrosis, hyperkalemia, hyperphosphatemia, QT dispersion, QT–prolonging medication, sympathetic overactivity/autonomic nerve dysfunction and electrolyte and volume shifts during hemodialysis sessions. 

Successful preventive strategies applied in the general population, such as the use of β–blockers, angiotensin–converting enzyme inhibitors, angiotensin II receptor antagonists, statins and implantable cardioverter–defibrillators do not appear to offer benefit in dialysis patients.

Long–chain n–3 fatty acids are polyunsaturated fatty acids commonly found in marine and plant oils. They have beneficial effects on major cardiovascular outcomes, including sudden death, due to antiatherogenic, anti–inflammatory, antithrombotic, antihypertensive and triglyceride–lowering effects. 

Three major n–3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are found in fatty fish (salmon, bluefish, mackerel, arctic char, sardines, and swordfish), and alpha–linolenic acid (ALA), found in specific vegetable oils (soybean, rapeseed, and flaxseed), walnuts, and some green vegetables (brussels sprouts, kale, spinach and salad greens). 

The new recommendation is that dialysis patients should be supplemented with n–3 fatty acids.

About HCFI: The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on" Hands only CPR" of 59455 people since 1st November 2012. 

The CPR 10 Mantra is – "within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute."