Impact of Fish Intake Frequency on Cardiovascular Disease-Specific Survival in Hemodialysis Patients

TL;DR

This study found that higher fish intake frequency may increase cardiovascular disease mortality risk in hemodialysis patients.

Contribution

The study identifies fish intake frequency as an independent predictor of cardiovascular disease-specific survival in hemodialysis patients.

Findings

Patients with ≥4 weekly fish meals had significantly lower CVD-specific survival at 72 months.

Higher fish intake frequency was an independent predictor of CVD-specific mortality.

No association was found between fish intake and new CVD onset or blood sampling data.

Abstract

Cardiovascular disease (CVD) is the leading cause of death in hemodialysis patients (HPs). As a food source, fish contains both CVD-preventive and CVD-promoting fatty acids; however, there is no consensus on fish consumption as a preventive measure for CVD in HPs. This single-center longitudinal cohort study aims to assess the impact of fish intake frequency (FIF) per week on CVD in Japanese HPs.

Upon the initiation of the study, 148 HPs were evaluated to determine the FIF, and blood samples were analyzed. These patients were then monitored for 6 years.

The relationships between each FIF and blood sampling data, CVD-specific survival (CSS), and new CVD-free survival (nCFS) were statistically calculated using Kaplan-Meier survival curves.

During the observation period, 65 deaths were reported, 16 of which were attributed to CVD. Further, 53 patients developed new CVD onset, and no association was found between the FIF and blood sampling data. Based on the Kaplan-Meier survival curves, there was a significant difference in the CSS probability rates at 72 months between patients with an FIF of ≥4 (0.719, 95% confidence interval (CI): 0.530-0.842) and those with an FIF of ≤3 (0.930, 95% CI: 0.851-0.968) (p < 0.01). However, the nCFS probability at 72 months did not significantly differ between patients with an FIF of ≥4 and those with an FIF of ≤3. Multivariate Cox proportional hazards regression showed that an FIF of ≥4 (hazard ratio: 3.64, 95% CI: 1.22-10.9, p = 0.02) was an independent predictor of CSS, but not of nCFS.

It was suggested that a higher FIF in HPs might be one of the risks for developing CVD with increased mortality.

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