Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts. (18th January 2023)

• Record Type: Journal Article
• Authors: Ong, Kwok Leung; Marklund, Matti; Huang, Liping; Rye, Kerry-Anne; Hui, Nicholas; Pan, Xiong-Fei; Rebholz, Casey M; Kim, Hyunju; Steffen, Lyn M; van Westing, Anniek C; Geleijnse, Johanna M; Hoogeveen, Ellen K; Chen, Yun-Yu; Chien, Kuo-Liong; Fretts, Amanda M; Lemaitre, Rozenn N; Imamura, Fumiaki; Forouhi, Nita G; Wareham, Nicholas J; Birukov, Anna; Jäger, Susanne; Kuxhaus, Olga; Schulze, Matthias B; de Mello, Vanessa Derenji; Tuomilehto, Jaakko; Uusitupa, Matti; Lindström, Jaana; Tintle, Nathan; Harris, William S; Yamasaki, Keisuke; Hirakawa, Yoichiro; Ninomiya, Toshiharu; Tanaka, Toshiko; Ferrucci, Luigi; Bandinelli, Stefania; Virtanen, Jyrki K; Voutilainen, Ari; Jayasena, Tharusha; Thalamuthu, Anbupalam; Poljak, Anne; Bustamante, Sonia; Sachdev, Perminder S; Senn, Mackenzie K; Rich, Stephen S; Tsai, Michael Y; Wood, Alexis C; Laakso, Markku; Lankinen, Maria; Yang, Xiaowei; Sun, Liang; Li, Huaixing; Lin, Xu; Nowak, Christoph; Ärnlöv, Johan; Risérus, Ulf; Lind, Lars; Le Goff, Mélanie; Samieri, Cécilia; Helmer, Catherine; Qian, Frank; Micha, Renata; Tin, Adrienne; Köttgen, Anna; de Boer, Ian H; Siscovick, David S; Mozaffarian, Dariush; Wu, Jason HY;
• Is Part Of: BMJ. Volume 380(2023)
• Publication Date: 2023-01-18
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Periodicals; 610
• DOI: 10.1136/bmj-2022-072909
• Languages: English
• ISSNs: 0007-1447

Abstract

Abstract: Objective: To assess the prospective associations of circulating levels of omega 3 polyunsaturated fatty acid (n-3 PUFA) biomarkers (including plant derived α linolenic acid and seafood derived eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid) with incident chronic kidney disease (CKD). Design: Pooled analysis. Data sources: A consortium of 19 studies from 12 countries identified up to May 2020. Study selection: Prospective studies with measured n-3 PUFA biomarker data and incident CKD based on estimated glomerular filtration rate. Data extraction and synthesis: Each participating cohort conducted de novo analysis with prespecified and consistent exposures, outcomes, covariates, and models. The results were pooled across cohorts using inverse variance weighted meta-analysis. Main outcome measures: Primary outcome of incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m 2 . In a sensitivity analysis, incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m 2 and <75% of baseline rate. Results: 25 570 participants were included in the primary outcome analysis and 4944 (19.3%) developed incident CKD during follow-up (weighted median 11.3 years). In multivariable adjusted models, higher levels of total seafood n-3 PUFAs were associated with a lower incident CKD risk (relative risk per interquintile range 0.92, 95% confidence interval 0.86 to 0.98; P=0.009, I 2 =9.9%). In categorical analyses, participants with total seafood n-3 PUFA level in the highest fifth had 13% lower risk of incident CKD compared with those in the lowest fifth (0.87, 0.80 to 0.96; P=0.005, I 2 =0.0%). Plant derived α linolenic acid levels were not associated with incident CKD (1.00, 0.94 to 1.06; P=0.94, I 2 =5.8%). Similar results were obtained in the sensitivity analysis. The association appeared consistent across subgroups by age (≥60 v <60 years), estimated glomerular filtration rate (60-89 v ≥90 mL/min/1.73 m 2 ), hypertension, diabetes, and coronary heart disease at baseline. Conclusions: Higher seafood derived n-3 PUFA levels were associated with lower risk of incident CKD, although this association was not found for plant derived n-3 PUFAs. These results support a favourable role for seafood derived n-3 PUFAs in preventing CKD.