n-3 fatty acids reduce proteinuria in patients with chronic glomerular disease

n-3 fatty acids reduce proteinuria in patients with chronic glomerular disease. Dietary supplementation with n-3 polyunsaturated fatty acids (n-3 PUFA) has been shown to reduce proteinuria in experimental models of renal diseases, but their potential role in the treatment of human renal disease is unknown. We administered n-3 PUFA in the form of triglycerides [with eicosapentenoic (EPA) + docosahexaenoic (DHA) = 3 g/day into 4 patients] and of ethyl esters (EPA + DHA=7.7 g/day) into 10 patients (one patient twice) with chronic glomerular disease (membranous glomerulonephritis and focal glomerular sclerosis), all diagnosed histologically. Serum albumin was >2.4 g/dl and serum creatinine 2 (mean ± SEM, from 490 ± 70 ng/ml at baseline, to 342 ± 147 ng/ml at 6 weeks, P 2 excretion (as a reflection of renal TXA 2 production) and urinary 6-keto-PGF 1α excretion (as a reflection of renal PGI 2 production), assayed by extraction, chromatographic separation and RIA with antibodies cross-reacting with metabolites of the n-3 series, were both similarly reduced by the ethyl ester treatment (for TXB 2 : 7.8 ± 1.7 ng/hr at week 0; 4.2 ± 0.6 ng/hr at week 6, P=0.06; for 6-keto-PGF 1α : 24.4 ± 5.1 ng/hr at week 0; 16.4 ± 2.9 ng/hr at week 6, P=0.09). Serum albumin, creatinine and creatinine clearance did not change significantly throughout the study. The high dose regimen, however, caused a significant reduction in proteinuria (from 3.7 ± 1.0 g/24 hr at week 0 to 2.6 ± 0.7 g/24 hr at week 6, P