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Plasma Polyunsaturated Fatty Acids and the Decline of Renal Function

¹ Tuscany Regional Agency, Florence, Italy;² Johns Hopkins School of Medicine, Baltimore, MD;³ Geriatric Unit, Azienda Sanitaria Firenze, Florence, Italy;⁴ Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, MD;⁵ Institute of Gerontology and Geriatrics, Perugia University Medical School, Perugia, Italy;⁶ Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, MD.

^aAddress correspondence to this author at: Luigi Ferrucci, National Institute on Aging, Longitudinal Studies Section, ASTRA Unit, Harbor Hospital 5th Floor, 3001 S. Hanover St., Baltimore, MD 21225. Fax 410-350-7304; e-mail ferruccilu{at}grc.nia.nih.gov.

Background: Recent studies suggest an association between polyunsaturated fatty acids (PUFAs) and the development of chronic kidney disease. The aim of this study was to examine the relationship between PUFAs and renal function in older adults.

Methods: We performed a cross-sectional and prospective analysis of 931 adults, 65 years old, enrolled in the InCHIANTI study, a population-based cohort in Tuscany, Italy. Plasma PUFAs were measured at enrollment, and creatinine clearance was estimated by the Cockcroft-Gault equation at baseline and after 3-year follow-up.

Results: At enrollment, participants with higher creatinine clearance had higher concentrations of HDL cholesterol, total plasma PUFAs, plasma n-3 fatty acid (FA), and plasma n-6 FA and lower triglycerides. From enrollment to the 3-year follow-up visit, creatinine clearance declined by 7.8 (12.2) mL/min (P <0.0001). Baseline total plasma PUFAs, n-3 FA, n-6 FA, and linoleic, linolenic, and arachidonic acids were strong independent predictors of less steep decline in creatinine clearance from baseline to follow-up (P <0.0001, after adjusting for baseline creatinine clearance). After adjusting for baseline creatinine, baseline total plasma PUFAs, n-3 FA, and linoleic, linolenic, and arachidonic acids were negatively associated with creatinine at 3-year follow-up. Participants with higher plasma PUFAs at enrollment had a lower risk of developing renal insufficiency, defined by a creatinine clearance <60 mL/min, during 3-year follow-up.

Conclusion: High PUFA concentrations, both n-3 FA and n-6 FA, may attenuate the age-associated decline in renal function among older community-dwelling women and men.

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