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Open Access Review

Effects of fish oil on serum lipid profile in dialysis patients: a systematic review and meta-analysis of randomized controlled trials

Wei Zhu1*, Chongya Dong2, Han Du1, He Zhang1, Jie Chen1, Xiaohong Hu3 and Feng Hu1

Author Affiliations

1 Department of Nephrology, The 150th Hospital of PLA, Luoyang, China

2 Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China

3 Department of Nephrology, Kidney Institude of PLA, Changzheng Hospital, Second Military Medical University, Shanghai, China

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Lipids in Health and Disease 2014, 13:127  doi:10.1186/1476-511X-13-127

Published: 8 August 2014

Abstract

Background

The effects of fish oil supplements on lipid profile in dialysis patients are controversial. With increasing interest in the potential health benefits of fish oil, it is important to explore its real effects.

Objective

We aimed to identify and quantify the effects of fish oil on triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in dialysis patients.

Methods

PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were searched for relevant trials of fish oil and lipid profile in dialysis patients. We identified 209 potential studies and included 13 randomized controlled trials. Eligible studies, determined by consensus using predefined criteria, were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and a meta-analysis was performed.

Results

Compared with the control group, serum TG and TC levels in the fish oil group were reduced by 0.23 mmol/L (95% CI, −0.31, −0.14, P <0.01) and 0.12 mmol/L (95% CI, −0.23, −0.01, P =0.03), respectively. HDL-C levels were increased by 0.20 mmol/L (95% CI, 0.01, 0.40, P <0.01) attributable to fish oil. In contrast, fish oil did not influence serum LDL-C levels. Subgroup analysis showed the effects of fish oil were stronger in subjects with higher baseline TG levels, and the long-term intervention (>12w) demonstrated a tendency towards greater improvement of serum HDL-C and LDL-C levels compared with short-term intervention (≤12 w). However, both of the changes were not statistically significant in meta-regression analysis. There were no obvious difference in effects of different doses and components of fish oil on lipid levels.

Conclusion

Fish oil supplements reduced serum TG and TC levels, and increased HDL-C levels, without affecting LDL-C levels among dialysis patients. It should benefit patients at risk of cardiovascular diseases. Based on randomized controlled trials, we suggested a daily supplement dose of fish oil for dialysis patients of >1 g, but a high dose might not be necessary.

Keywords:
Fish oil; Dialysis; Lipid; Meta-analysis