Effect of fish oil supplementation on graft patency and cardiovascular events among patients with new synthetic arteriovenous hemodialysis grafts: a randomized controlled trial.
Effect of fish oil supplementation on graft patency and cardiovascular events among patients with new synthetic arteriovenous hemodialysis grafts: a randomized controlled trial.
复制标题
DOI：
10.1001/jama.2012.3473
复制
发表时间：
2012-05-02
影响因子：
120.7
通讯作者：
Stanley, Kenneth
中科院分区：
文献类型：
--
作者：
Lok, Charmaine E.;Moist, Louise;Hemmelgarn, Brenda R.;Tonelli, Marcello;Vazquez, Miguel A.;Dorval, Marc;Oliver, Matthew;Donnelly, Sandra;Allon, Michael;Stanley, Kenneth
动静脉移植物是血液透析血管通路的重要选择，但容易发生复发性狭窄和血栓形成。确定鱼油对动静脉移植物通畅性和心血管事件的影响。随机、双盲、对照临床试验2003年11月至2010年12月在15个北美透析中心进行的FISH研究招募了201名患有5期慢性肾脏疾病的参与者（50%女性，63%白人，53%的糖尿病患者），并在移植物生成后随访12个月。（4×1克）或匹配的安慰剂。12个月随访期间发生移植物血栓形成或放射或手术干预的受试者比例。鱼油和安慰剂接受者之间的主要结局风险没有差异（48/99 [48%] vs 60/97 [62%];相对风险0.78 [95%CI，0.60-1.03; P = 0.064]）。然而，鱼油组的移植失败率较低（3.43 vs 5.95/1000访问日;发病率比（IRR）0.58 [95%CI，0.44-0.75; P < 0.001）。在鱼油组中，（1.71 vs 3.41/1，000访问日; IRR 0.50 [95% CI，0.35-0.72; P < 0.001）;纠正干预较少（2.89 vs 4.92/1000访问日; IRR 0.59 [95% CI，0.44-0.78; P < 0.001]），改善了无心血管事件生存率;风险比0.43 [95% CI，0.19-0.96; P=0.035）和12个月时收缩压降低（平均-3.61 vs + 4.49 mmHg [95% CI-15.4--0.85]; P=0.014）。鱼油摄入并没有降低移植物形成后12个月内天然通畅性丧失的患者比例;然而，它确实降低了血栓形成的发生率和时间，减少了维持通畅性的纠正干预措施的需要，并与改善心血管结局相关。controlled-trials.com标识符：ISRCTN 15838383
Arteriovenous grafts, an important option for hemodialysis vascular access, are prone to recurrent stenosis and thrombosis. To determine the effect of fish oil on arteriovenous graft patency and cardiovascular events. Randomized, double-blind, controlled clinical trial (FISH Study) conducted at 15 North American dialysis centres from November 2003-December 2010 enrolled 201 participants with stage 5 chronic kidney disease (50% female, 63% Caucasian, 53% diabetic) and followed them for 12 months after graft creation Random allocation to daily fish oil capsules (4×1 gram) or matching placebo on day 7 after graft creation. The proportion of participants experiencing a graft thrombosis or radiological or surgical intervention during 12 months follow-up. The risk of the primary outcome did not differ between fish oil and placebo recipients (48/99 [48%] versus 60/97 [62%]; relative risk 0.78 [95% CI, 0.60–1.03; P = 0.064]). However, the rate of graft failure was lower in the fish oil group (3.43 versus 5.95 per 1,000 access days; incidence rate ratio (IRR) 0.58 [95% CI, 0.44–0.75; P < 0.001). In the fish oil group, there were half as many thrombosis events (1.71 versus 3.41 per 1,000 access days; IRR 0.50 [95% CI, 0.35–0.72; P < 0.001); fewer corrective interventions (2.89 versus 4.92 per 1,000 access days; IRR 0.59 [95% CI, 0.44–0.78; P < 0.001), improved cardiovascular event-free survival; hazard ratio 0.43 [95% CI, 0.19–0.96; P=0.035) and lower systolic blood pressure by 12 months (average −3.61 versus + 4.49 mmHg [95% CI −15.4–−0.85]; P=0.014). aily fish oil ingestion did not reduce the proportion of patients with loss of native patency within 12 months of graft creation; however, it did reduce the rate and time to thrombosis, the need for corrective interventions to maintain patency, and was associated with improved cardiovascular outcomes. controlled-trials.com Identifier: ISRCTN 15838383
登录
查看更多内容
DOI：
10.1053/jren.2000.16326
发表时间：
2000-10-01
期刊：
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
影响因子：
--
作者：
Khajehdehi, P
通讯作者：
Khajehdehi, P
影响因子：
158.5
作者：
Dixon, Bradley S.;Beck, Gerald J.;Feldman, Harold I.
通讯作者：
Feldman, Harold I.
影响因子：
3.2
作者：
Bowden, Rodney G.;Wilson, Ronald L.;Leutholtz, Brian C.
通讯作者：
Leutholtz, Brian C.
DOI：
10.1097/01.asn.0000081661.10246.33
发表时间：
2003-09-01
影响因子：
13.6
作者：
Kaufman, JS;O'Connor, TZ;Peduzzi, PN
通讯作者：
Peduzzi, PN
影响因子：
2.7
作者：
LAN, KKG;DEMETS, DL
通讯作者：
DEMETS, DL