HONOLULU, HAWAII. IgA nephropathy is likely to recur in patients who receive a kidney transplant as a result of having developed end-stage renal disease. It is estimated that recurrence rates are as high as 60% and that the transplant eventually fails in 30-60% of patients with IgA nephropathy. It is therefore not uncommon for these patients to have two transplants separated by 10 years or less. A medical researcher at the University of Hawaii now reports that transplant failure can be postponed quite significantly by supplementation with fish oils. He describes the case of a 34-year-old man who was observed to have blood in his urine (hematuria) in 1979. His kidney function deteriorated, by March 1986 he required dialysis treatments, and 2 months later he received a kidney transplant and was then put on prednisone and cyclosporine. In 1991 he was diagnosed with IgA nephropathy and a year later he was again put on dialysis, and subsequently received a second kidney transplant; thus his first transplant lasted 6 years.
In May 1997, 5 years after the second transplant, the patient again developed IgA nephropathy and was then placed on fish oil supplementation (2.1 grams/day of EPA plus 1.4 grams/day of DHA). The amount of protein in his urine (proteinuria) decreased from 3299 mg/day before fish oil therapy to 458 mg/day after therapy. A normal value is less than 165 mg/day. Ten years after the second transplant there was no sign of rejection and the man’s kidney function was well preserved. The researcher points out that this case clearly indicates the progressive nature of IgA nephropathy even if the kidney is replaced. It also clearly demonstrates a beneficial effect of fish oil therapy on post-transplantation IgA nephropathy, but this effect needs to be confirmed in larger trials.
Ng, Roland. Fish oil therapy in recurrent IgA nephropathy. Annals of Internal Medicine, Vol. 138, June 17, 2003, pp. 1011-12