Inverse relationship between long-chain n-3 fatty acids and risk of sudden cardiac death in patients starting hemodialysis
Open accessAbstract
Experimental and clinical evidence suggests that long-chain n-3 fatty acids may protect against sudden cardiac death, the leading cause of mortality in hemodialysis patients. Here we investigated whether long-chain n-3 fatty acids have a protective relationship with sudden cardiac death in 100 patients who died of sudden cardiac death during the first year of starting hemodialysis and 300 patients who survived. Individuals were selected from a nationally representative cohort of over 1000 US hemodialysis units in 2004-2005. The odds of sudden cardiac death were calculated by quartile of long-chain n-3 fatty acid levels over the first year. There was a significant inverse relationship between long-chain n-3 fatty acids and the risk of sudden cardiac death even after adjusting for relevant comorbid conditions, biochemical values, and dietary fats. The odds of sudden cardiac death at 1 year for the second, third, and fourth quartile groups of long-chain n-3 fatty acids were 0.37, 0.22, and 0.20, respectively, compared with the lowest quartile. This significant inverse relationship was maintained even during the highest-risk first few months on hemodialysis. Thus, long-chain n-3 fatty acids are strongly and independently associated with a lower risk of sudden cardiac death in hemodialysis patients throughout the first year of hemodialysis.
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Three studies have examined the relationship between marine derived n-3 fatty acids and cardiovascular outcomes; however, all were performed in patients on hemodialysis and used a less tailored n-3 fatty acid formulation than icosapent ethyl.
“Three studies have examined the relationship between marine derived n-3 fatty acids and cardiovascular outcomes; however, all were performed in patients on hemodialysis and used a less tailored n-3 fatty acid formulation than icosapent ethyl.29–31”
From Benefits of Icosapent Ethyl Across the Range of Kidney Function in Patients With Established Cardiovascular Disease or Diabetes: REDUCE-IT RENAL (2021) · cites this paper as [31]
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Ten tips for the first hemodialysis sessions
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- Authors
- Friedman, A. N., Yu, Z., Tabbey, R., Denski, C., Tamez, H., Wenger, J., Thadhani, R., Li, Y., & Watkins, B. A.
- Affiliations
- Indiana University Indianapolis (US)
- Massachusetts General Hospital (US)
- University of Connecticut (US)
- Corresponding author
- Friedman, Allon N.
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 2013-06
- Volume
- 83
- Issue
- 6
- Pages
- 1130-1135
- ISSN
- 0085-2538 (ISSN-L)
- PMC
- PMC3655118
- OpenAlex
- W2025329008
- Cited by
- 54
- References
- 41
- Citations by year
- 2026: 4 · 2025: 2 · 2022: 2 · 2021: 7 · 2020: 1 · 2019: 6 · 2018: 7 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 3 · 2013: 5
- FWCI
- 6.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Kidney International (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- Fresenius Medical Care North America
- National Institutes of Health (DK084403)
- National Heart, Lung, and Blood Institute (R01HL112746, HL112746)
- National Institute of Diabetes and Digestive and Kidney Diseases (K24DK094872, DK094872, DK084403, R21DK084403)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- n-3 long-chain polyunsaturated fatty acids, omega-3 fatty acids, sudden cardiac death, hemodialysis initiation, end-stage renal disease, cardiovascular mortality, serum fatty acid levels, dietary fat
- MeSH terms
- Aged, Aged, 80 and over, Female, Renal Dialysis, Humans, Male, Middle Aged, Risk Factors, Time Factors, United States, Biomarkers, Fatty Acids, Omega-3, Chi-Square Distribution, Logistic Models, Odds Ratio, Case-Control Studies, Death, Sudden, Cardiac, Renal Insufficiency, Chronic
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