The supplements of fatty acids vitamin D and omega-3 (often sold as fish oil) do not help people with type 2 diabetes from chronic kidney disease, according to results from the largest clinical study to date. these supplements in this patient population.
The paper was published today in JAMA and was presented at the American Nephrology Association conference in Washington, D.C.
“We were optimistic for both these interventions, vitamin D and fish oil, but they do not appear to be very effective for this purpose,” said Dr. Ian de Boer, the author of the paper. He is a medical professor at the University of Washington Medical School and co-director of the Kidney Research Institute, collaboration with UW Medicine and North Western Kidney Centers.
Of the 28 million Americans living with type 2 diabetes, said of Boer, develops about 40 percent chronic disease, a condition that the kidneys cannot remove waste and fluids from the body adequately. This affects a person's health in numerous ways and can progress to kidney failure. It increases the risk of cardiovascular and death events.
Previous studies on animal samples and cell cultures have suggested that vitamin D and fish oil supplements have inflammatory and other properties that could prevent the progression of chronic diabetes. Research has also found combinations between kidney decay and lower levels of vitamin D and lower fish intake.
“Many people use the supplements they expect to have beneficial kidney and cardiovascular effects,” said Boer. “We wanted to clarify this study whether these supplements have any kidney benefits in adults with diabetes. Even if it was not the expected outcome, the closure of a chapter is useful for both patients and clinicians and researchers. ”
The study was carried out as part of VITAM D and OmegA-3 TriaL (VITAL) nationwide. The investigators appointed a five-year study of kidney function in 1,312 adults with type 2 diabetes in the trial. There were no cardiovascular or cancer diseases seen by the adults (men ,50, women ≥55), and most did not start with kidney disease symptoms.
Participants submitted blood and urine samples to establish the estimated rate of glomerol filtration – eGFR, measurement of renal waste performance – and presence of protein in urine. They were then randomly assigned to one of four treatment groups:
- 370 people received supplements of fatty acids vitamin D and omega-3 (fish oil)
- 333 vitamin D and placebo received fish oil
- Placebo received vitamin D and capsule for fish oil 289
- Two of the two places were found
Blood and urine samples were collected at two years and again at four or five years after randomization. On average, the kidney function decreased by around 15% during the study. The extent of deterioration has not changed significantly if participants have been assigned vitamin D or placebo, or omega-3 placebo acids or placebo. There were also no significant differences in urine protein excretion.
“The VITAL trial is to evaluate the overall benefits and risks associated with these supplements, and the effects on the kidney function are an important part of the response. The current study responds to a key issue that promotes public health, ”said Dr. JoAnn Manson, senior author of the study and director of the main VITAL trial. She is chief executive of preventive medicine in Brigham Hospital and Women and a professor of medicine at Harvard Medical School.
In addition to the University of Washington and Harvard, the research also involved the Department of Biomedical Science at Cedars-Sinai Medical Center in Los Angeles. Funding was provided by the National Institute for Diabetes and Digestion and Kidney Diseases (R01DK088762) and North West Kidney Centers.
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