BACKGROUND: Blood levels of the anti-inflammatory and cardioprotective omega-3 eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids are determined primarily by dietary consumption. There is reason to believe that hemodialysis patients are at risk for inadequate omega-3 intake and, consequently, low blood levels.

METHODS: This question was tested in 75 long-term hemodialysis patients and 25 matched controls by measuring fasting, predialysis plasma and red blood cell (RBC) fatty acid levels using gas chromatography and performing a fish-consumption survey.

RESULTS: Sixty-seven percent of patients did not meet American Heart Association fish-consumption guidelines for healthy persons. Compared with controls, patients had lower plasma omega-3 levels (mean % wt: DHA, 1.33 +/- 0.38 [SD] versus 1.51 +/- 0.36; P = 0.0370; omega-3 index [ie, EPA plus DHA], 1.67 +/- 0.49 versus 1.92 +/- 0.40; P = 0.0249). RBC levels, which estimate more long-term consumption, showed mixed results (EPA, 0.29 +/- 0.08 versus 0.33 +/- 0.11; P = 0.0816; DHA, 4.65 +/- 0.92 versus 3.16 +/- 1.15; P < 0.0001; omega-3 index, 4.95 +/- 0.95 versus 3.49 +/- 1.22; P < 0.0001). RBC omega-3 levels in patients roughly reflected fish consumption. Independent predictors of plasma and RBC omega-3 levels at the 0.05 level of significance included age, race, sex, alcohol use, and fish servings.

CONCLUSION: Hemodialysis patients consumed fish in quantities far below current American Heart Association recommendations and manifested suboptimal omega-3 levels given their high heart disease risk. These results identify a potentially modifiable cardiovascular risk factor.