Fish Oil and IgA Nephropathy

IgA Nephropathy (IgAN) is also known as Berger’s Disease. IgAN is a common kidney disease that occurs slowly over many years. It is characterized by the accumulation of immunogloubulin A (IgA) in the kidneys interfering with the filtration process of the body leading to high blood pressure, blood and protein in the urine, and swollen hands and feet. While many patients live long lives without significant problems, others continue the disease process and have complete renal failure. There is no cure for this disease but there are medications and fish oil that can help. According to a Mayo Clinic report based on trials and observational reports between 1994 and 1999, fish oil showed mild to moderate usefulness when kidney IgA nephropathy.

Fish oil remains a point of contention among nephrologists. There are essentially three groups: those who believe it is effective, those who believe the trials were flawed, and it is not effective, and those who recommend it but are not sure of its effectiveness. People who have been diagnosed with Berger’s disease should consult with their physician before beginning any therapy with fish oil as the dosages required are quite a bit higher than what is based on any label and in most cases above the dosages that are considered as “safe” by the Food and Drug Administration.

Fish oil appears, in some studies, to delay the progression of IgAN towards end stage renal disease over the long term. There is also a reduction of protein in the urine noted for some patients but this has not been proven in any studies. At the very best this is a mild reduction and is not a proven benefit of fish oil. Current philosophy is that an omega-3 fatty acid supplement may provide a slowing of the disease process in the beginning but may not provide any benefit over the life of the disease. As studies continue, proponents of fish oil hope that it will show increased effectiveness.

Instead of taking supplements, many people choose to increase their intake of oily fish such as mackerel, salmon, albacore tuna, cod, and herring. Fish are the best natural source of EPA and DHA since it has already been converted to a usable form. Plant sources of these essential fatty acids include the precursor to EPA and DHA in the form of alpha-linoleic acid also known as ALA. It comes from sources such as olive oil, flax seed, some marine vegetation, tree nuts, and safflower oil.

Patients taking fish oil to assist with their IgAN treatment should be aware of potential side effects and drug interactions. Patients with extremely high blood pressure may need to avoid the blood thinning action of fish oil due to the increased possibly of a cerebrovascular accident. There may also be an interaction between NSAIDs (non-steroidal anti-inflammatory drugs) again related to the blood thinning action of essential fatty acids. Large doses of fish oil have also been have also been related to immune system depression and may cause additional problems with patients who have a suppressed immune system.

Taking a fish oil supplement for IgAN is still under study and you should consult with your nephrologist before beginning any treatment. There is a long-term study being conducted by the Columbia Hospital at Medical Center in Dallas, TX. It is hoped that this study will shed some light on the effects of fish oil for patients with IgAN. Currently the effectiveness cannot be determined with any certainty but it is hoped that the short-term benefits that some patients receive may translate into longer-term benefits as studies continue. Despite the possible drug interactions and gastric upset that sometimes accompany fish oil, there have been no significant adverse reactions in any of the noted studies

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