Intakes of long-chain omega-3 polyunsaturated fatty acids and non-fried fish in relation to incidence of chronic kidney disease in young adults: a 25-year follow-up

  • Inwhee Park
  • Pengcheng Xun
  • Cari Lewis Tsinovoi
  • Philip Klemmer
  • Kiang Liu
  • Ka HeEmail author
Original Contribution



The prevalence of chronic kidney disease (CKD) is increasing rapidly in many countries and has become a major public health concern. Although intakes of long-chain omega-3 polyunsaturated fatty acids (LCω3PUFA) and its food source—fish—may have renal protective effects, little is known about the longitudinal association between these dietary factors and CKD incidence.


A total of 4133 healthy individuals of black and white race aged 18–30 at baseline (1985–1986) from the Coronary Artery Risk Development in Young Adults study were enrolled and followed up over 25 years. LCω3PUFA and fish intake were assessed by an interview-based dietary history questionnaire at baseline, year 7 (1992–1993) and 20 (2005–2006).


Four hundred and eighty-nine incident cases of CKD were identified. After adjustment for potential confounders, LCω3PUFA intake was inversely associated with CKD incidence [HR = 0.73 (95% CI 0.60–0.89), P = 0.002, with one standard division (0.19 g/day) increment in LCω3PUFA]. This inverse association was persisted among females [0.64 (95% CI 0.48, 0.84; P = 0.002], but not males (Pinteraction = 0.070). A marginal significant inverse association was also found between non-fried fish consumption and CKD incidence (HR = 0.86, 95% CI 0.73, 1.01; P = 0.073).


Dietary LCω3PUFA intake was inversely associated with incidence of CKD among American young adults over 25 years of follow-up. The suggestive evidence of the inverse association between non-fried fish consumption with CKD incidence needs further confirmation.


Chronic kidney disease Proteinuria Fish Long-chain omega-3 polyunsaturated fatty acids 



African American


Coronary Artery Risk Development in Young Adults


Chronic kidney disease


Estimated glomerular filtration rate


Eicosapentaenoic acid


Exercise units


Glomerular filtration rate


Hydrargyrum: mercury


Long-chain omega-3 polyunsaturated fatty acids


Physical activity





We thank the investigators and the staff of the CARDIA Study for their valuable contributions.

Author contribution

The manuscript has been read and approved by all coauthors. All individuals listed as authors have substantially contributed to the manuscript preparation, and no one other than the authors listed has contributed significantly to this study. Specifically, IP, PX, and KH contributed to the conception and design of the study. IP, PX, CLT, PK, KL, and KH contributed to the analysis and interpretation of data. All of the listed authors contributed to drafting of the manuscript and revising it critically for important intellectual content.


The Coronary Artery Risk Development in Young Adults Study (CARDIA) is supported by contracts HHSN268201300025C, HHSN268201300026C, HHSN268201300027C, HSN268201300028C, HHSN268201300029C, and HHSN268200900041C from the National Heart, Lung, and Blood Institute (NHLBI), the Intramural Research Program of the National Institute on Aging (NIA), and an intra-agency agreement between NIA and NHLBI (AG0005). This study was partially supported by grants from the NIH (R01HL081572 and R01ES021735, to Ka He). Inwhee Park was supported by Ajou University School of Medicine, the Republic of Korea. The study sponsor had no role in study design, analysis, or interpretation of data.

Compliance with ethical standards

Conflict of interest

None of the authors has any conflict of interest to declare.

Supplementary material

394_2019_2022_MOESM1_ESM.docx (35 kb)
Supplementary material 1 (DOCX 34 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Inwhee Park
    • 1
    • 2
  • Pengcheng Xun
    • 1
  • Cari Lewis Tsinovoi
    • 1
  • Philip Klemmer
    • 3
  • Kiang Liu
    • 4
  • Ka He
    • 1
    Email author
  1. 1.Department of Epidemiology and Biostatistics, School of Public Health-BloomingtonIndiana UniversityBloomingtonUSA
  2. 2.Department of Nephrology, School of MedicineAjou UniversitySuwonRepublic of Korea
  3. 3.Division of Nephrology and Hypertension, School of MedicineUniversity of North CarolinaChapel HillUSA
  4. 4.Department of Preventive Medicine, Feinberg School of MedicineNorthwestern UniversityChicagoUSA

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