Higher Serum Omega-3 Polyunsaturated Fatty Acid Content Is Associated with Improved Long-Term Cardiovascular and...

Background: Patients with chronic kidney disease (CKD) exhibit reduced serum levels of n-3 polyunsaturated fatty acids (PUFA). Alterations in fatty acid profiles may contribute to increased cardiovascular risk and potentially accelerate CKD progression. Aim: The aim of the study was to assess whether fatty acid profiles measured a decade earlier predicted CKD progression and cardiovascular events. Additionally, the impact of dietary patterns at baseline was evaluated. Methods: The study comprised 77 patients with CKD whose serum fatty acid profiles had been assessed approximately a decade earlier. Follow-up data on CKD progression, cardiovascular events, and all-cause mortality were collected. Dietary habits were assessed using a food frequency questionnaire. The composite endpoint was defined as renal replacement therapy initiation or occurrence of stroke, myocardial infarction, or death. Results: Higher n-3 PUFA content was significantly associated with a lower risk of the composite endpoint in Cox regression analysis (HR = 0.63; 95% CI: 0.40-0.99; p = 0.044). Significant differences in event-free survival were observed in patients with higher n-3/n-6 PUFA ratios (log-rank test, χ² = 4.58, p = 0.032). Patients who experienced stroke or myocardial infarction had significantly higher levels of n-6 PUFA (32.85% vs. 29.94% Mann-Whitney U test, p = 0.037) and lower n-3/n-6 PUFA ratios (0.07 vs. 0.08, Mann-Whitney U test, p = 0.045). Eicosapentaenoic acid (EPA) content was significantly lower at baseline in patients who required renal replacement therapy during follow-up compared with those who did not experience this outcome (0.66% [0.48-0.82] vs. 0.88% [0.64-1.13], Mann-Whitney U test, p = 0.02). Conclusions: Lower serum n-3 PUFA levels were observed in patients who reached the composite endpoint during follow-up. A higher n-3/n-6 PUFA ratio showed a protective effect in survival analysis, and higher EPA content was associated with a lower risk of renal replacement therapy initiation. A more favorable fatty acid profile may be linked to improved cardiovascular and renal outcomes. Further studies are needed to clarify the role of fatty acid profiles in long-term outcomes among patients with CKD, in whom cardiovascular disease remains the leading cause of death.