Association of polyunsaturated fatty acids with improved heart rate variability and cardiovascular events in patients with end-stage renal disease receiving maintenance dialysis: a systematic review and meta-analysis of randomized controlled trials
Objective : Apart from dietary restriction and medical therapy, the benefits of cardiovascular protection offered by polyunsaturated fatty acid (PUFA) supplements in patients with ESRD receiving maintenance dialysis remain unclear. This systematic review and meta-analysis examined the effects of PUF...
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| Veröffentlicht in: | Food & function 2021-09, Vol.12 (17), p.89-899 |
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| creator | Chou, Chu-Lin Chen, Jin-Shuen Kang, Yi-No Chen, Yuan-Jen Fang, Te-Chao |
| description | Objective
: Apart from dietary restriction and medical therapy, the benefits of cardiovascular protection offered by polyunsaturated fatty acid (PUFA) supplements in patients with ESRD receiving maintenance dialysis remain unclear. This systematic review and meta-analysis examined the effects of PUFAs on blood pressure, heart rate (HR), HR variability (HRV), and cardiovascular disease (CVD) prognosis.
Methods
: We identified randomized controlled trials (RCTs) from Embase, PubMed (including MEDLINE), and Web of Science. We included seven RCTs that involved 724 patients with ESRD receiving dialysis and PUFA supplements.
Results
: The data indicated that compared with the control group, the PUFA group demonstrated decreased cardiovascular events (Peto odds ratio = 0.52, 95% confidence interval [CI] = 0.32 to 0.85,
P
= 0.009) and HRV (changes in the mean HR [mean difference = −2.59, 95% CI = −4.91 to −0.26,
P
= 0.03,
I
2
= 0%]; mean RR interval [MD = 29.03, 95% CI = 5.43 to 52.63,
P
= 0.02,
I
2
= 0%]; mean of the standard deviation of all normal RR intervals for all 5 min segments [MD = 2.73, 95% CI = 0.48 to 4.99,
P
= 0.02,
I
2
= 0%], and square root of the mean of the sum of the squares of differences between adjacent intervals [MD = 2.03, 95% CI = 0.04 to 4.03,
P
= 0.05,
I
2
= 0%]).
Conclusion
: PUFA supplements appeared to improve CVD prognosis in patients receiving dialysis. Additional RCTs with longer follow-up periods need to clarify the benefits of PUFA supplements in this patient population.
Objective
: Apart from dietary restriction and medical therapy, the benefits of cardiovascular protection offered by polyunsaturated fatty acid (PUFA) supplements in patients with ESRD receiving maintenance dialysis remain unclear. |
| doi_str_mv | 10.1039/d1fo00510c |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_rsc_p</sourceid><recordid>TN_cdi_proquest_journals_2566252357</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2553821828</sourcerecordid><originalsourceid>FETCH-LOGICAL-c337t-fcf0cca0be774ca29178415aa8a37cdf436cd6b3cb2d27d49b35cd413b3b4e363</originalsourceid><addsrcrecordid>eNpdks9rFTEQxxdRbKm9eFcCXkRYzY_96a08WxUKvSh4W2aT2TZlN3lmsluef7nHZt9rK5jLTPL98J2ZMFn2WvCPgqv2kxGD57wUXD_LjiUvZF6V_Nfzx7xoq6PslOiWp6Patmmbl9mRKmRTNbw6zv6eEXltIVrvmB_Y1o-72RHEOUBEwwaIccdAW0PszsYbZqdt8EtSbhBCZCvFFggWejvaFXWGaQjG-gVIzyMEhgu6SMw6tk119vneCp3JKcI1soAORmYsIdB602gX667ZBNbFpDmNSYVxR5Y-M2C0o4hTMtMJXize7ctOGCEHd8DWYUJ69ZP9k7rV3sXgxzGlMTU70qvsxZACnj7Ek-znxfmPzbf88urr983ZZa6VqmM-6IFrDbzHui40yFbUTSFKgAZUrc1QqEqbqle6l0bWpmh7VWpTCNWrvkBVqZPs_cE3fdvvGSl2kyWN4wgO_UydLEvVSNHIJqHv_kNv_RzSPCtVVbKUqqwT9eFA6eCJAg7dNtgJwq4TvFtXovsiLq72K7FJ8NsHy7mf0DyhjwuQgDcHIJB-Uv_tlLoHnf3DuA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2566252357</pqid></control><display><type>article</type><title>Association of polyunsaturated fatty acids with improved heart rate variability and cardiovascular events in patients with end-stage renal disease receiving maintenance dialysis: a systematic review and meta-analysis of randomized controlled trials</title><source>MEDLINE</source><source>Royal Society Of Chemistry Journals 2008-</source><creator>Chou, Chu-Lin ; Chen, Jin-Shuen ; Kang, Yi-No ; Chen, Yuan-Jen ; Fang, Te-Chao</creator><creatorcontrib>Chou, Chu-Lin ; Chen, Jin-Shuen ; Kang, Yi-No ; Chen, Yuan-Jen ; Fang, Te-Chao</creatorcontrib><description>Objective
: Apart from dietary restriction and medical therapy, the benefits of cardiovascular protection offered by polyunsaturated fatty acid (PUFA) supplements in patients with ESRD receiving maintenance dialysis remain unclear. This systematic review and meta-analysis examined the effects of PUFAs on blood pressure, heart rate (HR), HR variability (HRV), and cardiovascular disease (CVD) prognosis.
Methods
: We identified randomized controlled trials (RCTs) from Embase, PubMed (including MEDLINE), and Web of Science. We included seven RCTs that involved 724 patients with ESRD receiving dialysis and PUFA supplements.
Results
: The data indicated that compared with the control group, the PUFA group demonstrated decreased cardiovascular events (Peto odds ratio = 0.52, 95% confidence interval [CI] = 0.32 to 0.85,
P
= 0.009) and HRV (changes in the mean HR [mean difference = −2.59, 95% CI = −4.91 to −0.26,
P
= 0.03,
I
2
= 0%]; mean RR interval [MD = 29.03, 95% CI = 5.43 to 52.63,
P
= 0.02,
I
2
= 0%]; mean of the standard deviation of all normal RR intervals for all 5 min segments [MD = 2.73, 95% CI = 0.48 to 4.99,
P
= 0.02,
I
2
= 0%], and square root of the mean of the sum of the squares of differences between adjacent intervals [MD = 2.03, 95% CI = 0.04 to 4.03,
P
= 0.05,
I
2
= 0%]).
Conclusion
: PUFA supplements appeared to improve CVD prognosis in patients receiving dialysis. Additional RCTs with longer follow-up periods need to clarify the benefits of PUFA supplements in this patient population.
Objective
: Apart from dietary restriction and medical therapy, the benefits of cardiovascular protection offered by polyunsaturated fatty acid (PUFA) supplements in patients with ESRD receiving maintenance dialysis remain unclear.</description><identifier>ISSN: 2042-6496</identifier><identifier>EISSN: 2042-650X</identifier><identifier>DOI: 10.1039/d1fo00510c</identifier><identifier>PMID: 34286806</identifier><language>eng</language><publisher>England: Royal Society of Chemistry</publisher><subject>Aged ; Blood pressure ; Cardiovascular diseases ; Cardiovascular Diseases - drug therapy ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - physiopathology ; Clinical trials ; Confidence intervals ; Dialysis ; Diet ; Dietary restrictions ; Dietary Supplements ; End-stage renal disease ; Fatty acids ; Fatty Acids, Unsaturated - administration & dosage ; Female ; Heart diseases ; Heart rate ; Heart Rate - drug effects ; Hemodialysis ; Humans ; Kidney diseases ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - therapy ; Maintenance ; Male ; Meta-analysis ; Middle Aged ; Patients ; Polyunsaturated fatty acids ; Prognosis ; Randomized Controlled Trials as Topic ; Renal Dialysis ; Systematic review ; Variability</subject><ispartof>Food & function, 2021-09, Vol.12 (17), p.89-899</ispartof><rights>Copyright Royal Society of Chemistry 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-fcf0cca0be774ca29178415aa8a37cdf436cd6b3cb2d27d49b35cd413b3b4e363</citedby><cites>FETCH-LOGICAL-c337t-fcf0cca0be774ca29178415aa8a37cdf436cd6b3cb2d27d49b35cd413b3b4e363</cites><orcidid>0000-0002-5577-9280</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27911,27912</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34286806$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chou, Chu-Lin</creatorcontrib><creatorcontrib>Chen, Jin-Shuen</creatorcontrib><creatorcontrib>Kang, Yi-No</creatorcontrib><creatorcontrib>Chen, Yuan-Jen</creatorcontrib><creatorcontrib>Fang, Te-Chao</creatorcontrib><title>Association of polyunsaturated fatty acids with improved heart rate variability and cardiovascular events in patients with end-stage renal disease receiving maintenance dialysis: a systematic review and meta-analysis of randomized controlled trials</title><title>Food & function</title><addtitle>Food Funct</addtitle><description>Objective
: Apart from dietary restriction and medical therapy, the benefits of cardiovascular protection offered by polyunsaturated fatty acid (PUFA) supplements in patients with ESRD receiving maintenance dialysis remain unclear. This systematic review and meta-analysis examined the effects of PUFAs on blood pressure, heart rate (HR), HR variability (HRV), and cardiovascular disease (CVD) prognosis.
Methods
: We identified randomized controlled trials (RCTs) from Embase, PubMed (including MEDLINE), and Web of Science. We included seven RCTs that involved 724 patients with ESRD receiving dialysis and PUFA supplements.
Results
: The data indicated that compared with the control group, the PUFA group demonstrated decreased cardiovascular events (Peto odds ratio = 0.52, 95% confidence interval [CI] = 0.32 to 0.85,
P
= 0.009) and HRV (changes in the mean HR [mean difference = −2.59, 95% CI = −4.91 to −0.26,
P
= 0.03,
I
2
= 0%]; mean RR interval [MD = 29.03, 95% CI = 5.43 to 52.63,
P
= 0.02,
I
2
= 0%]; mean of the standard deviation of all normal RR intervals for all 5 min segments [MD = 2.73, 95% CI = 0.48 to 4.99,
P
= 0.02,
I
2
= 0%], and square root of the mean of the sum of the squares of differences between adjacent intervals [MD = 2.03, 95% CI = 0.04 to 4.03,
P
= 0.05,
I
2
= 0%]).
Conclusion
: PUFA supplements appeared to improve CVD prognosis in patients receiving dialysis. Additional RCTs with longer follow-up periods need to clarify the benefits of PUFA supplements in this patient population.
Objective
: Apart from dietary restriction and medical therapy, the benefits of cardiovascular protection offered by polyunsaturated fatty acid (PUFA) supplements in patients with ESRD receiving maintenance dialysis remain unclear.</description><subject>Aged</subject><subject>Blood pressure</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - drug therapy</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - physiopathology</subject><subject>Clinical trials</subject><subject>Confidence intervals</subject><subject>Dialysis</subject><subject>Diet</subject><subject>Dietary restrictions</subject><subject>Dietary Supplements</subject><subject>End-stage renal disease</subject><subject>Fatty acids</subject><subject>Fatty Acids, Unsaturated - administration & dosage</subject><subject>Female</subject><subject>Heart diseases</subject><subject>Heart rate</subject><subject>Heart Rate - drug effects</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Maintenance</subject><subject>Male</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Polyunsaturated fatty acids</subject><subject>Prognosis</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Renal Dialysis</subject><subject>Systematic review</subject><subject>Variability</subject><issn>2042-6496</issn><issn>2042-650X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdks9rFTEQxxdRbKm9eFcCXkRYzY_96a08WxUKvSh4W2aT2TZlN3lmsluef7nHZt9rK5jLTPL98J2ZMFn2WvCPgqv2kxGD57wUXD_LjiUvZF6V_Nfzx7xoq6PslOiWp6Patmmbl9mRKmRTNbw6zv6eEXltIVrvmB_Y1o-72RHEOUBEwwaIccdAW0PszsYbZqdt8EtSbhBCZCvFFggWejvaFXWGaQjG-gVIzyMEhgu6SMw6tk119vneCp3JKcI1soAORmYsIdB602gX667ZBNbFpDmNSYVxR5Y-M2C0o4hTMtMJXize7ctOGCEHd8DWYUJ69ZP9k7rV3sXgxzGlMTU70qvsxZACnj7Ek-znxfmPzbf88urr983ZZa6VqmM-6IFrDbzHui40yFbUTSFKgAZUrc1QqEqbqle6l0bWpmh7VWpTCNWrvkBVqZPs_cE3fdvvGSl2kyWN4wgO_UydLEvVSNHIJqHv_kNv_RzSPCtVVbKUqqwT9eFA6eCJAg7dNtgJwq4TvFtXovsiLq72K7FJ8NsHy7mf0DyhjwuQgDcHIJB-Uv_tlLoHnf3DuA</recordid><startdate>20210907</startdate><enddate>20210907</enddate><creator>Chou, Chu-Lin</creator><creator>Chen, Jin-Shuen</creator><creator>Kang, Yi-No</creator><creator>Chen, Yuan-Jen</creator><creator>Fang, Te-Chao</creator><general>Royal Society of Chemistry</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7T7</scope><scope>7TO</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5577-9280</orcidid></search><sort><creationdate>20210907</creationdate><title>Association of polyunsaturated fatty acids with improved heart rate variability and cardiovascular events in patients with end-stage renal disease receiving maintenance dialysis: a systematic review and meta-analysis of randomized controlled trials</title><author>Chou, Chu-Lin ; Chen, Jin-Shuen ; Kang, Yi-No ; Chen, Yuan-Jen ; Fang, Te-Chao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-fcf0cca0be774ca29178415aa8a37cdf436cd6b3cb2d27d49b35cd413b3b4e363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Blood pressure</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - drug therapy</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cardiovascular Diseases - physiopathology</topic><topic>Clinical trials</topic><topic>Confidence intervals</topic><topic>Dialysis</topic><topic>Diet</topic><topic>Dietary restrictions</topic><topic>Dietary Supplements</topic><topic>End-stage renal disease</topic><topic>Fatty acids</topic><topic>Fatty Acids, Unsaturated - administration & dosage</topic><topic>Female</topic><topic>Heart diseases</topic><topic>Heart rate</topic><topic>Heart Rate - drug effects</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>Kidney diseases</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Maintenance</topic><topic>Male</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Polyunsaturated fatty acids</topic><topic>Prognosis</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Renal Dialysis</topic><topic>Systematic review</topic><topic>Variability</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chou, Chu-Lin</creatorcontrib><creatorcontrib>Chen, Jin-Shuen</creatorcontrib><creatorcontrib>Kang, Yi-No</creatorcontrib><creatorcontrib>Chen, Yuan-Jen</creatorcontrib><creatorcontrib>Fang, Te-Chao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Food & function</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chou, Chu-Lin</au><au>Chen, Jin-Shuen</au><au>Kang, Yi-No</au><au>Chen, Yuan-Jen</au><au>Fang, Te-Chao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of polyunsaturated fatty acids with improved heart rate variability and cardiovascular events in patients with end-stage renal disease receiving maintenance dialysis: a systematic review and meta-analysis of randomized controlled trials</atitle><jtitle>Food & function</jtitle><addtitle>Food Funct</addtitle><date>2021-09-07</date><risdate>2021</risdate><volume>12</volume><issue>17</issue><spage>89</spage><epage>899</epage><pages>89-899</pages><issn>2042-6496</issn><eissn>2042-650X</eissn><abstract>Objective
: Apart from dietary restriction and medical therapy, the benefits of cardiovascular protection offered by polyunsaturated fatty acid (PUFA) supplements in patients with ESRD receiving maintenance dialysis remain unclear. This systematic review and meta-analysis examined the effects of PUFAs on blood pressure, heart rate (HR), HR variability (HRV), and cardiovascular disease (CVD) prognosis.
Methods
: We identified randomized controlled trials (RCTs) from Embase, PubMed (including MEDLINE), and Web of Science. We included seven RCTs that involved 724 patients with ESRD receiving dialysis and PUFA supplements.
Results
: The data indicated that compared with the control group, the PUFA group demonstrated decreased cardiovascular events (Peto odds ratio = 0.52, 95% confidence interval [CI] = 0.32 to 0.85,
P
= 0.009) and HRV (changes in the mean HR [mean difference = −2.59, 95% CI = −4.91 to −0.26,
P
= 0.03,
I
2
= 0%]; mean RR interval [MD = 29.03, 95% CI = 5.43 to 52.63,
P
= 0.02,
I
2
= 0%]; mean of the standard deviation of all normal RR intervals for all 5 min segments [MD = 2.73, 95% CI = 0.48 to 4.99,
P
= 0.02,
I
2
= 0%], and square root of the mean of the sum of the squares of differences between adjacent intervals [MD = 2.03, 95% CI = 0.04 to 4.03,
P
= 0.05,
I
2
= 0%]).
Conclusion
: PUFA supplements appeared to improve CVD prognosis in patients receiving dialysis. Additional RCTs with longer follow-up periods need to clarify the benefits of PUFA supplements in this patient population.
Objective
: Apart from dietary restriction and medical therapy, the benefits of cardiovascular protection offered by polyunsaturated fatty acid (PUFA) supplements in patients with ESRD receiving maintenance dialysis remain unclear.</abstract><cop>England</cop><pub>Royal Society of Chemistry</pub><pmid>34286806</pmid><doi>10.1039/d1fo00510c</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-5577-9280</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Food & function, 2021-09, Vol.12 (17), p.89-899 |
| issn | 2042-6496 2042-650X |
| language | eng |
| recordid | cdi_proquest_journals_2566252357 |
| source | MEDLINE; Royal Society Of Chemistry Journals 2008- |
| subjects | Aged Blood pressure Cardiovascular diseases Cardiovascular Diseases - drug therapy Cardiovascular Diseases - etiology Cardiovascular Diseases - physiopathology Clinical trials Confidence intervals Dialysis Diet Dietary restrictions Dietary Supplements End-stage renal disease Fatty acids Fatty Acids, Unsaturated - administration & dosage Female Heart diseases Heart rate Heart Rate - drug effects Hemodialysis Humans Kidney diseases Kidney Failure, Chronic - complications Kidney Failure, Chronic - therapy Maintenance Male Meta-analysis Middle Aged Patients Polyunsaturated fatty acids Prognosis Randomized Controlled Trials as Topic Renal Dialysis Systematic review Variability |
| title | Association of polyunsaturated fatty acids with improved heart rate variability and cardiovascular events in patients with end-stage renal disease receiving maintenance dialysis: a systematic review and meta-analysis of randomized controlled trials |
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