International Urology and Nephrology

, Volume 49, Issue 10, pp 1851–1858 | Cite as

The impact of fish oil and wheat germ oil combination on mineral-bone and inflammatory markers in maintenance hemodialysis patients: a randomized, double-blind, placebo-controlled clinical trial

  • Hadeer ZakariaEmail author
  • Tarek M. Mostafa
  • Gamal A. El-Azab
  • Ahmed M. Abd El Wahab
  • Heba Elshahawy
  • Nagy AH Sayed-Ahmed
Nephrology - Original Paper



This study aimed to examine the impact of combined supplementation of fish oil (FO) with antioxidants like wheat germ oil (WGO) on mineral-bone and inflammatory markers in maintenance HD patients.


This randomized, double-blind, placebo-controlled trial involved 46 HD patients who were randomly assigned into two groups to receive daily 3000 mg of FO [1053 mg omega-3 fatty acids (ω-3 FAs)] plus 300 mg of WGO [0.765 mg vitamin E] or placebo for 4 months. Blood concentrations of hemoglobin (Hgb), white blood cells, mineral-bone parameters including serum calcium (Ca), phosphorus, calcium–phosphorus product, parathyroid hormone, alkaline phosphatase, and osteoprotegerin and serum concentrations of inflammatory markers including high-sensitivity C-reactive protein, ferritin, and uric acid were measured before and after the intervention.


Eighty-seven percentage of patients in each group completed the study. The mean serum Ca levels increased significantly in the supplemented group at the end of study (p = 0.0016), and this increment was also significant as compared to placebo group (p = 0.0418). No significant alterations were observed in the other measured parameters within each group during the study (as p values were >0.05).


FO plus WGO supplementation showed beneficial effect on serum Ca levels of HD patients without any statistically significant effect on other mineral-bone and inflammatory markers. Further investigations are required to confirm it.


Fish oil Wheat germ oil Mineral-bone Inflammation Hemodialysis 



The authors would like to thank Sedico Pharmaceutical Company, Egypt, for providing both placebo and Omega-3 plus® soft-gel capsules free of charge. The authors also acknowledge the great efforts and contributions of all staff members of the hemodialysis unit of Mansoura University Hospital and all participants in this study since without them, this study would have never been accomplished.

Compliance with ethical standards

Conflict of interest

All the authors declare no conflict of interest in this work.

Ethical approval

The study protocol was approved by the institutional research board (IRB) of Mansoura University (Code number: MS/15.09.34). All participants signed a written informed consent before the start of the study.


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Department of PharmacyMansoura Fever HospitalMansouraEgypt
  2. 2.Department of Clinical PharmacyFaculty of PharmacyTantaEgypt
  3. 3.Department of Internal MedicineFaculty of MedicineMansouraEgypt
  4. 4.Department of Clinical PathologyFaculty of MedicineMansouraEgypt

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