promega and Glomerulonephritis--IGA

The effect of a "very low dose" of purified omega-3 fatty acids (PFA) in the progression of severe IgA nephropathy (IgAN) was tested, in a randomized, prospective, controlled trial.. Fourteen patients were assigned to receive a "very low dose" of PFA (0.85 g EPA and 0.57 g PHA) and 14 patients were treated symptomatically and used as controls. Both groups were similar in terms of serum creatinine (Scr) and glomerular filtration rate (GFR) at baseline. Patients were treated for 4 years. The primary end-points were an increase of 50% or more in Scr or a decrease of 50% or more in GFR at the end of the study.. During treatment, 1 patient (7%) in the PFA group and 6 (43%) in the control group had an increase of 50% or more in their Scr (p<0.01). Also, 1 patient (7%) in the PFA group and 7 (50%) in the control group had a decrease of 50% or more in GFR (p<0.007). The mean annual change in Scr was 0.2 mg/dL in the PFA group and 1.0 mg/dL in the control group (p<0.01). The mean annual change in GFR was -1.4 mL/min in the PFA group and -3.0 mL/min in the control group (p <0.001). One patient in the PFA group (7%) and 6 patients in the control group (43%) (p<0.01) developed end-stage renal disease during the period of observation.. A "very low dose" of PFA is also effective in slowing renal progression in high-risk patients with IgAN and particularly those with advanced renal disease.

Topics: Adult; Creatinine; Docosahexaenoic Acids; Dose-Response Relationship, Drug; Drug Combinations; Eicosapentaenoic Acid; Female; Follow-Up Studies; Glomerular Filtration Rate; Glomerulonephritis, IGA; Humans; Male; Middle Aged; Prospective Studies; Proteinuria; Renal Insufficiency; Severity of Illness Index

The effect of fish-oil dietary supplement on the rate of progression of renal failure in 11 patients with IgA nephropathy was investigated by comparing the slope of the plot of reciprocal serum creatinine versus time before and after supplement. After supplement, the slope significantly decreased in two patients, increased in two, and was not significantly altered in the remainder. Before supplement, serum IgA, IgA circulating immune complexes, and in-vitro Ig production were not significantly different from normal controls. After supplement, urinary protein transiently increased, serum IgA circulating immune complexes decreased, and serum triglyceride and in-vitro platelet aggregation tended to decrease. Only the change in serum IgG and spontaneous in-vitro IgG production correlated with the change in the rate of renal functional deterioration. No clinical or biochemical parameters before supplement predicted the subsequent response. In patients with IgA nephropathy, non-immune factors probably contribute to progression of renal failure, and in these patients fish-oil dietary supplement has either no demonstrable or an unpredictable effect.

Topics: Adult; Antigen-Antibody Complex; Creatinine; Docosahexaenoic Acids; Drug Combinations; Drug Evaluation; Eicosapentaenoic Acid; Fatty Acids, Omega-3; Female; Fish Oils; Glomerulonephritis, IGA; Humans; Male; Middle Aged; Platelet Aggregation; Proteinuria