{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T23:29:28Z","timestamp":1793662168782,"version":"4.5.1"},"reference-count":63,"publisher":"BMJ","license":[{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2022,12,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the prospective associations of circulating levels of omega 3 polyunsaturated fatty acid (n-3 PUFA) biomarkers (including plant derived \u03b1 linolenic acid and seafood derived eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid) with incident chronic kidney disease (CKD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Pooled analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>A consortium of 19 studies from 12 countries identified up to May 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study selection<\/jats:title>\n                    <jats:p>Prospective studies with measured n-3 PUFA biomarker data and incident CKD based on estimated glomerular filtration rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Each participating cohort conducted de novo analysis with prespecified and consistent exposures, outcomes, covariates, and models. The results were pooled across cohorts using inverse variance weighted meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>\n                      Primary outcome of incident CKD was defined as new onset estimated glomerular filtration rate &lt;60 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      . In a sensitivity analysis, incident CKD was defined as new onset estimated glomerular filtration rate &lt;60 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      and &lt;75% of baseline rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      25\u2009570 participants were included in the primary outcome analysis and 4944 (19.3%) developed incident CKD during follow-up (weighted median 11.3 years). In multivariable adjusted models, higher levels of total seafood n-3 PUFAs were associated with a lower incident CKD risk (relative risk per interquintile range 0.92, 95% confidence interval 0.86 to 0.98; P=0.009, I\n                      <jats:sup>2<\/jats:sup>\n                      =9.9%). In categorical analyses, participants with total seafood n-3 PUFA level in the highest fifth had 13% lower risk of incident CKD compared with those in the lowest fifth (0.87, 0.80 to 0.96; P=0.005, I\n                      <jats:sup>2<\/jats:sup>\n                      =0.0%). Plant derived \u03b1 linolenic acid levels were not associated with incident CKD (1.00, 0.94 to 1.06; P=0.94, I\n                      <jats:sup>2<\/jats:sup>\n                      =5.8%). Similar results were obtained in the sensitivity analysis. The association appeared consistent across subgroups by age (\u226560\n                      <jats:italic>v<\/jats:italic>\n                      &lt;60 years), estimated glomerular filtration rate (60-89\n                      <jats:italic>v<\/jats:italic>\n                      \u226590 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ), hypertension, diabetes, and coronary heart disease at baseline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher seafood derived n-3 PUFA levels were associated with lower risk of incident CKD, although this association was not found for plant derived n-3 PUFAs. These results support a favourable role for seafood derived n-3 PUFAs in preventing CKD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2022-072909","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T20:00:11Z","timestamp":1674072011000},"page":"e072909","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":73,"title":["Association of omega 3 polyunsaturated fatty acids with incident chronic kidney disease: pooled analysis of 19 cohorts"],"prefix":"10.1136","volume":"380","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7229-7614","authenticated-orcid":false,"given":"Kwok Leung","family":"Ong","sequence":"first","affiliation":[{"name":"Lipid Research Group, School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matti","family":"Marklund","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia"},{"name":"The Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"},{"name":"Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Huang","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry-Anne","family":"Rye","sequence":"additional","affiliation":[{"name":"Lipid Research Group, School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Hui","sequence":"additional","affiliation":[{"name":"Lipid Research Group, School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong-Fei","family":"Pan","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia"},{"name":"Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China"},{"name":"Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey M","family":"Rebholz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunju","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyn M","family":"Steffen","sequence":"additional","affiliation":[{"name":"University of Minnesota School of Public Health, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anniek C","family":"van Westing","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna M","family":"Geleijnse","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen K","family":"Hoogeveen","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Jeroen Bosch Hospital, Den Bosch, The Netherlands"},{"name":"Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University, Taipei, Taiwan"},{"name":"Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan"},{"name":"Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, 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Cambridge School of Clinical Medicine, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nita G","family":"Forouhi","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J","family":"Wareham","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Birukov","sequence":"additional","affiliation":[{"name":"Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany"},{"name":"German Center for Diabetes Research (DZD), M\u00fcnchen-Neuherberg, 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School of Medicine, University of Eastern Finland, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tharusha","family":"Jayasena","sequence":"additional","affiliation":[{"name":"Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anbupalam","family":"Thalamuthu","sequence":"additional","affiliation":[{"name":"Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Poljak","sequence":"additional","affiliation":[{"name":"Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Bustamante","sequence":"additional","affiliation":[{"name":"Mark Wainwright Analytical Centre, University of New South 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Y","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis C","family":"Wood","sequence":"additional","affiliation":[{"name":"USDA\/ARS Children\u2019s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku","family":"Laakso","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland"},{"name":"Department of Medicine, Kuopio University Hospital, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Lankinen","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Yang","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Sun","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaixing","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Lin","sequence":"additional","affiliation":[{"name":"Shanghai Institute of Nutrition and Health, University 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