Effect of intravenous omega-3 fatty acid infusion and hemodialysis on fatty acid composition of free fatty acids and phospholipids in patients with end-stage renal disease

Background: Patients treated with hemodialysis (HD) have been reported to have decreased levels of ω‐3 polyunsaturated fatty acids (PUFAs) in plasma and cells. The aim of this study was to investigate the effect of ω‐3 PUFAs administered intravenously during HD, as well as the effect of HD treatment, on the fatty acid composition of plasma free fatty acids (FFAs), plasma phospholipids, and platelet phospholipids. Methods: Forty‐four HD patients were randomized to groups receiving either a single dose of a lipid emulsion containing 4.1 g of ω‐3 PUFAs or placebo (saline) administered intravenously during HD. Blood was drawn immediately before (baseline) and after (4 hours) HD and before the next HD session (48 hours). Fatty acid composition was measured using gas chromatography. Results: The increase in ω‐3 FFAs was greater in the ω‐3 PUFA group compared with the placebo group, whereas the increase in total FFAs was similar between the 2 groups. In the ω‐3 PUFA group, ω‐3 PUFAs in plasma phospholipids were higher after 48 hours than at baseline, and in platelet phospholipids, ω‐3 PUFAs increased after 4 hours. In the placebo group, no changes were observed in ω‐3 PUFAs in plasma and platelet phospholipids. Conclusions: Intravenous ω‐3 PUFAs administered during HD caused a transient selective increase in ω‐3 FFA concentration. Furthermore, ω‐3 PUFAs were rapidly incorporated into platelets, and the content of ω‐3 PUFAs in plasma phospholipids increased after 48 hours.