Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts

Kwok Leung Ong , Matti Marklund , Liping Huang , Kerry-Anne Rye , Nicholas Hui , Xiong-Fei Pan , Casey M. Rebholz , Hyunju Kim , Lyn M. Steffen , Anniek C. van Westing , Johanna M. Geleijnse , Ellen K. Hoogeveen , Yun-Yu Chen , Kuo-Liong Chien , Amanda M. Fretts , Rozenn N. Lemaitre , Fumiaki Imamura , Nita G. Forouhi , Nicholas J. Wareham , Anna Birukov , Susanne Jager , Olga Kuxhaus , Matthias B. Schulze , Vanessa Derenji de Mello , Jaakko Tuomilehto , Matti Uusitupa , Jaana Lindstrom , Nathan Tintle , William S. Harris , Keisuke Yamasaki , Yoichiro Hirakawa , Toshiharu Ninomiya , Toshiko Tanaka , Luigi Ferrucci , Stefania Bandinelli , Jyrki K. Virtanen , Ari Voutilainen , Tharusha Jayasena , Anbupalam Thalamuthu , Anne Poljak , Sonia Bustamante , Perminder S. Sachdev , Mackenzie K. Senn , Stephen S. Rich , Michael Y. Tsai , Alexis C. Wood , Markku Laakso , Maria Lankinen , Xiaowei Yang , Liang Sun , Huaixing Li , Xu Lin , Christoph Nowak , Johan Arnlov , Ulf Riserus , Lars Lind , Melanie Le Goff (1) , Cecilia Samieri (1) , Catherine Helmer (1) , Frank Qian , Renata Micha , Adrienne Tin , Anna Kottgen , Ian H. de Boer , David S. Siscovick , Dariush Mozaffarian , Jason Hy Wu

1 BPH - Bordeaux population health

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.

Domaines: Santé publique et épidémiologie

Kwok Leung Ong, Matti Marklund, Liping Huang, Kerry-Anne Rye, Nicholas Hui, et al.. Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts. BMJ, 2023, 380, ⟨10.1136/bmj-2022-072909⟩. ⟨hal-04102401⟩