This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Despite improvements in the care of dialysis-dependent end stage renal disease patients, cardiovascular disease and mortality as well as other quality-of-life limiting derangements are highly prevalent. Though there are multiple causes for these problems, nutritional factors could be playing an important contributory role. Omega-3 and other essential fatty acids are dependent upon the consumption of fish and other foods. These fatty acids are responsible for the modulation of multiple biologic processes such as eicosanoid production, immune function, the inflammatory response, vasoreactivity, cell membrane stability, and platelet aggregation, among others. Though minimal information is available on the subject, chronic hemodialysis patients are theoretically susceptible to essential and omega-3 fatty acid deficiency for a host of reasons. This exploratory investigation will test the hypothesis that derangements of blood fatty acid status exist in the chronic hemodialysis population and are linked to a number of prevalent disease processes. Plasma and red cell membrane fatty acid levels will be measured in chronic hemodialysis patients and compared to healthy individuals. Results will be analyzed, and levels of omega-3 fatty acids correlated with fish intake, symptoms of pruritis, and level of oxidative stress. Finally, patients will be followed for 3 years to explore the relationship between baseline omega-3 levels and subsequent cardiovascular events. These investigations will ensure adequate preliminary data for future funding opportunities designed to support, among other studies, an interventional cardiovascular fish oil trial in hemodialysis patients.
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