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The effect of omega-3 fatty acids on depressive symptoms and inflammatory markers in maintenance hemodialysis patients: a randomized, placebo-controlled clinical trial

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Abstract

Purpose

This study was designed to investigate the effects of omega-3 fatty acids on depression and chronic inflammation in hemodialysis patients.

Method

Fifty-four maintenance hemodialysis patients were randomized to ingest two omega-3 (each containing 180 mg eicosapentaenoic acid and 120 mg docosahexaenoic acid) or placebo capsules, three times daily for 4 months. Main outcome measures: Beck Depression Inventory (BDI) score and serum levels of C-reactive protein (CRP), interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, ferritin, intact parathyroid hormone (iPTH), and ratios of IL-10 to IL-6 and IL-10 to TNF-α were measured at baseline and at the end of the study.

Results

Omega-3 supplement lowered BDI score significantly after 4 months of intervention. Among pro- and anti-inflammatory mediators, only serum ferritin level and IL-10 to IL-6 ratio showed significant changes in favor of omega-3 supplement during the study. In linear regression model adjusted for baseline values, omega-3 treatment was a significant predictor of reduced serum CRP, ferritin, and iPTH levels, and increased IL-10 to IL-6 ratio. No significant association was found between the anti-inflammatory and anti-depressant effects of omega-3 supplement.

Conclusions

Supplemental use of omega-3 fatty acids decreases depressive symptoms in hemodialysis patients apart from their anti-inflammatory effects.

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Acknowledgement

The authors thank Zahravi Pharmaceutical Co., Tehran, Iran for providing placebo free of charge and Dr. Amir Hekmat for kindly coordinating the researchers’ team and the pharmaceutical company. The authors also appreciate the valuable help of the hemodialysis nursing teams of Imam-Khomeini Hospital Complex and Sina Hospital, especially Mrs. Abdpoor.

Conflict of interest

The authors declare no conflict of interest.

Ethical conduct of research

The present study was supported by Tehran University of Medical Sciences (grant No: 17020). All participants signed written, informed consent forms. The study protocol was approved by the local ethics committee of Tehran University of Medical Sciences and registered in Iranian Registry of Clinical Trials (registry number: IRCT201202203043N5).

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Authors and Affiliations

  1. Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran

    Afshin Gharekhani

  2. Nephrology Research Center, Tehran University of Medical Sciences, 1417614411, P.O. Box: 14155/6451, Tehran, Iran

    Mohammad-Reza Khatami, Simin Dashti-Khavidaki & Effat Razeghi

  3. Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

    Simin Dashti-Khavidaki & Ahmad-Ali Noorbala

  4. Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Seyed-Saeed Hashemi-Nazari

  5. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad-Ali Mansournia

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  1. Afshin Gharekhani
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  2. Mohammad-Reza Khatami
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  3. Simin Dashti-Khavidaki
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Correspondence to Simin Dashti-Khavidaki.

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Gharekhani, A., Khatami, MR., Dashti-Khavidaki, S. et al. The effect of omega-3 fatty acids on depressive symptoms and inflammatory markers in maintenance hemodialysis patients: a randomized, placebo-controlled clinical trial. Eur J Clin Pharmacol 70, 655–665 (2014). https://doi.org/10.1007/s00228-014-1666-1

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  • DOI: https://doi.org/10.1007/s00228-014-1666-1

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