A large international study has found that taking a daily fish oil supplement can sharply lower the risk of serious heart-related complications in people undergoing dialysis for kidney failure. the research was co-led in Australia by Monash health adn the School of Clinical Sciences at Monash University.
Fish Oil Considerably Reduces Cardiovascular Risk in Dialysis Patients: Landmark PISCES Trial results
The groundbreaking PISCES trial, involving 1,228 participants receiving dialysis across 26 sites in Australia and Canada, has revealed a considerable benefit from daily fish oil supplementation. The findings, presented at the American Society of Nephrology Kidney Week 2025 and concurrently published in the new England Journal of Medicine,offer a potential new avenue for managing the exceptionally high cardiovascular risk faced by individuals with kidney failure.
Dramatic Reduction in Cardiovascular Events
Participants who received four grams of fish oil daily,containing the omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid),experienced a remarkable 43% reduction in serious cardiovascular events compared too those receiving a placebo. These events encompassed a range of life-threatening conditions,including heart attacks,strokes,cardiac-related deaths,and vascular-related amputations. This represents a critically important improvement in outcomes for a population where cardiovascular disease is the leading cause of mortality.
Why Dialysis Patients are at Higher Risk
Individuals with kidney failure requiring dialysis face an extraordinarily elevated risk of cardiovascular disease. Several factors contribute to this vulnerability:
- Uremic Toxins: The buildup of toxins in the blood due to impaired kidney function damages blood vessels and promotes inflammation.
- inflammation: Chronic inflammation is a hallmark of kidney failure and accelerates the development of atherosclerosis (plaque buildup in arteries).
- Fluid Overload: Dialysis patients frequently enough struggle with fluid overload, which strains the heart.
- Nutritional Deficiencies: Kidney disease and dialysis can lead to deficiencies in essential nutrients, including omega-3 fatty acids.
The Role of Omega-3 Fatty Acids
Omega-3 fatty acids, particularly EPA and DHA, are known for their anti-inflammatory properties and their ability to improve blood vessel function. Research suggests that these fatty acids can reduce triglyceride levels, lower blood pressure, and decrease the risk of blood clots – all factors that contribute to cardiovascular disease. The PISCES trial suggests that supplementing with these crucial nutrients can be particularly beneficial for those with kidney failure, who often have lower levels of EPA and DHA compared to the general population.
expert Commentary: Professor Kevan Polkinghorne
Adjunct Professor Kevan polkinghorne, a nephrologist at Monash Health and an adjunct at the School of Clinical Sciences at Monash University, spearheaded the Australian component of the PISCES trial. He emphasized the importance of these findings, stating, “Patients on dialysis have extremely high cardiovascular risk, and very few therapies have been shown to reduce that risk.In a field where many trials have been negative,this is a significant finding.”
Professor Polkinghorne further explained, “Dialysis patients typically have much lower levels of EPA and DHA than the general population. This may help explain the magnitude of benefit observed in this group.”
Significant Caveats: Specific to Dialysis Patients
Professor Polkinghorne and the research team are careful to highlight that the benefits observed in the PISCES trial are specific to individuals undergoing hemodialysis for kidney failure. The results should not be generalized to healthy individuals or other patient populations. Further research is needed to determine if similar benefits would be seen in people with earlier stages of kidney disease or in those with cardiovascular risk factors but normal kidney function.
Trial Funding and Collaboration
The Australian portion of the PISCES trial received funding from the National Health and Medical Research Council (NHMRC). Overall trial coordination was expertly managed by the Australasian Kidney Trials Network (AKTN). Approximately 200 Australian patients participated in the study, with 44 receiving treatment at Monash Health. International leadership for the PISCES trial was provided by Professor Charmaine Lok and her team at the University Health Network in Toronto and the University of calgary.
Future Implications and Next Steps
The PISCES trial provides compelling evidence for the potential of fish oil supplementation as a valuable adjunct therapy for reducing cardiovascular risk in dialysis patients. While further research is warranted to optimize dosage and identify potential long-term effects, these findings offer a promising new approach to improving the health and well-being of this vulnerable population. Clinicians are encouraged to discuss these results with their patients undergoing dialysis to determine if fish oil supplementation is appropriate as part of their overall care plan.
Published: 2026/01/15 13:52:57
