Abstract: SA-PO833

Dietary N-3 Polyunsaturated Fatty Acids (PUFA) Intake and Mortality in Adults on Hemodialysis: The DIET-HD Multinational Cohort Study

Session Information

Category: Dialysis

  • 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular


  • Saglimbene, Valeria Maria, University of Sydney, Sydney, Australia
  • Wong, Germaine, University of Sydney, Sydney, New South Wales, Australia
  • Craig, Jonathan C., University of Sydney/Children's Hospital, Sydney, New South Wales, Australia
  • Hegbrant, Jorgen BA, Diaverum Medical-Scientific Office, Lund, Sweden
  • Strippoli, Giovanni F.M., University of Bari, Bari, Italy
  • Ruospo, Marinella, Diaverum, Bari, Italy

Group or Team Name

  • For DIET-HD investigators

N-3 PUFA are protective factors for cardiovascular risk in the general population. However their role in hemodialysis patients, in whom the pathogenesis of cardiovascular disease is different, is uncertain.


The DIET-HD study is a prospective cohort study (January 2014-January 2016) in 9757 adults treated with hemodialysis in Europe and South America. The dietary N-3 PUFA intake was measured at baseline using the validated GA2LEN Food Frequency Questionnaire. Adjusted cox regression analyses clustered by country were conducted to evaluate the association between dietary N-3 PUFA intake and cardiovascular and all-cause mortality.


During a median follow up of 1.5 years (8108 person-years), there were 1214 deaths of which 515 were attributable to cardiovascular causes. Compared to patients with the lowest dietary N-3 PUFA intake (<0.37 g/wk), the hazard ratios (95% confidence intervals) for cardiovascular mortality among patients in the middle (0.37 to <1.8 g/wk) and highest (≥1.8 g/wk) tertiles of N-3 PUFA were 0.80 (0.64 to 1.00) and 1.13 (0.88 to 1.45), respectively; the hazard ratios for all-cause mortality were 0.95 (0.82 to 1.09) and 1.08 (0.92 to 1.28), respectively. Only one third of the study population consumed sufficient N-3 PUFA (at least 1.75 g/wk) as recommended for primary cardiovascular prevention, and less than 10% as recommended for secondary prevention (7-14 g/wk).


Dietary N-3 PUFA intake was not associated with cardiovascular or all-cause mortality in patients on hemodialysis. The possibility that higher dose N-3 PUFA, reached from supplementation, might mitigate cardiovascular risk has not been excluded.