Effectiveness of Eicosapentaenoic and Docosahexaenoic Acid Supplementation for Reducing Uremic Pruritus: A Meta-Analysis of Randomized Controlled Trials

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Background: Uremic pruritus is a distressing and common symptom in patients with end-stage renal disease. The development of uremic pruritus involves a multifactorial pathogenesis, including systemic inflammation, dysregulated immune responses, and altered opioid receptor activity. Omega-3 polyunsaturated fatty acids have been reported to mitigate uremic pruritus symptoms. Among omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been reported as potential candidates for alleviating uremic pruritus due to their anti-inflammatory properties. Methods: A meta-analysis of seven randomized controlled trials was conducted to evaluate the efficacy of omega-3 supplementation in alleviating uremic pruritus among patients affected with end-stage renal disease. Effect sizes were calculated using Hedges’ g with a random-effects model. Heterogeneity, sensitivity, and meta-regression analyses were performed to explore influencing factors. Results: A total of 266 participants were included for analysis. Omega-3 supplementation significantly reduced pruritus severity compared with placebo. Sensitivity analyses were conducted to exclude a single large trial contributing to the results. Meta-regression indicated that higher EPA, DHA, and total omega-3 dosages, and longer treatment duration, were associated with reduced severity of the uremic pruritus than the placebo. No serious adverse events were reported. Conclusions: Omega-3 fatty acid supplementation significantly alleviates uremic pruritus in patients with ESRD. These findings support the use of omega-3 fatty acids as a safe and effective adjunct therapy. Further large-scale, long-term trials are warranted to verify these results and assess the long-term effects and safety of omega-3 fatty acids in attenuating uremic pruritus.

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