الفهرس 
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Abstract
Summary
This work has been carried out to evaluate the improvement of anaemia, inflamation and malnutrition in patients with ESRD under maintainance dialysis . After supplementation of omega-3 fatty acids.
In our study randomized fifty 50 patients under maintainance hemodialysis are chosen from hemodialysis units in:
*Benha University 33 patients (66%) 16 male (32%)and 17 female (34%)
*Banha Fever hospital 17 patients (34%) 16 male (32%) and 1 female (2%).
Regular hemodialysis 3 sessions per week for four hours.
In our study, supplementation of these patients by dose of omega-3 capsules daily (each capsule contain 1g) for 6 months. Evaluation of clinical and laboratory data comparing results before and after 1,3and 6 months of supplementation.
As one of the marker of nutritional state:
- BMI, among female group increased significantly after 6 months of supplementation in comparing to baseline. (24.31± 5.68 kg\m²versus 25.4±5.82 kg\m², p= 0.017).
- MAC among female group increased significantly after 6 months of supplementation comparing to baseline (24.0±3.78cm vs 25.23±3.83cm, p=0.05).
-MCC among female group increased significantly after 6 months of supplementation comparing to baseline (29.12±3.85cm vs 29.69±4.30cm, p=0.02).
-serum albumin showed improvement at 6 months compared to baseline (3.88 ±0.34g\dLvs 4.81±0.69g\dL, p=0.001).
-Serum cholesterol is found in our study of limited decrease during study comaring with that at baseline versus after one, three and six months (159.62±33.15mg\dLvs 186.05 ±29.42mg\dL, 162.1±30.56mg\dl and 167.07±33.25mg\dl) respectively.
As one of marker of inflammatory state:
-C-reactive protien showed higly significant reduction level after 6 months of supplementation comparing to baseline(13.81±15.24mg\dLvs 7.98±7.84mg\dL, p=0.006).
In relation to this, we observe asignificant inverse correlation between serum albumin and CRP which may indicate the influence of an inflammatory process on serum albumin.
As one of marker for anemia:
-Hb level slightly elevated after 3months of study as compared with baseline (9.13±2.03g\dLvs 10.17±1.92, p=0.002).
Our study also described various potential outcome of omega-3 supplementation as cardioprotective effect through anti-inflammatory effect and affection on TAG level and other lipoprotein.
Pulse pressure reduced all over the study comparing between baseline and after 3 and 6 months of study (53 ±15.68 vs 45±11.8 and 44±9.46mmhg, p=0.006 and 0.002) respectively.
As for plasma TG, there is reduction in TG level as regard the dose of omega-3 supplementation we are found that reduction of their level all through our study as compared between baseline and after 6 months(174.72±67.45 mg\dLvs 117.32±29.8 mg\dL, p=0.001).
Also lipoprotiens specifically LDL level reduced by the end of study comparing before and after 6 months of study (118.97±23.94mg\dLvs 108.47±25.35mg\dL, p=0.022).
We found that omega-3 supplementation has hypoglycemic effect for a limit extent as compared at baseline and after 3 and 6 months of study (100.81±28.75mg\dLvs 79.82±19.06mg\dL and 80.56±13.27mg\dL, p0.027 and 0.039 respectively).
During our study about 11 patients (22%) reduced their dosage to 2 capsules\day due to tolerabilityand excess drug used, also about 13 patients (26%) can tolerate only one capsule\day as abdominal discomfort, nausea, fishyburp(2 cases only complaining of that effect) the rest of patients 26 (52%) complete full supra-physiological dose (>2g\day) for 6 months of study
Table(36) The comparison of studied variables before and after the supplementation with omega-3
p-value
After supplementation
Before supplementation
variable
0.017 S↑
25.4±5.82
24.31± 5.68 BMI(kg\m²)
0.05 S↑ 25.23±3.83 24.0±3.78
MAC(cm)
0.02 S↑ 29.69±4.30 29.12±3.85
MCC(cm)
0.002 HS↓ 44±9.46 53±15.68
Pulse pressure
0.07 NS↑ 9.63±1.81 9.13±2.03
Hb(g\dL)
0.001 HS↑ 4.81±0.69 3.88±0.34
S. Albumin
0.006 HS↓ 7.98±7.84 13.81±15.24
CRP(mg/dL)
0.039 S↓ 80.56±13.27
100.8±28.75
RBS(mg\dL)
0.4 NS↓ 167.07±33.25
159.62±62
S.cholesterol
0,001 HS↓ 117.32±29.8 179.72±67.45
S.TG
0.34 S↓ 73.84±12.46 118.97±23.94 LDL
BMI:body mass index ,MAC:mid-arm circumferance, MCC: mid-calf circumferance , Hb:hemoglobin , S.albumin: serum albumin , CRP:C-reactive protien , RBS:random blood sugar , S.cholesterol: serum cholesterol., S.TG: serum triglycerides. , LDL: low denisity lipoprotien.