Heart disease is the leading cause of death for people on dialysis, yet few therapies have shown clear success in reducing that risk.
Despite facing cardiovascular risks up to 20 times higher than the general population, individuals with kidney failure have had limited options to protect their heart health. Now, results of a new international study published in The New England Journal of Medicine offer a promising path forward.
The Protection against Incidences of Serious Cardiovascular Events Study (PISCES) trial with daily fish oil supplementation in dialysis patients, was led by Dr. Charmaine E. Lok, Senior Scientist, Toronto General Hospital Research Institute, and the University of Toronto.
The study followed 1,228 patients receiving hemodialysis at 26 sites in Canada and Australia. Participants were randomly given either daily fish oil capsules or placebo capsules and followed for 3.5 years.
The fish oil capsules contained omega-3 fatty acids, specifically EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These are natural substances found in fish that help reduce inflammation, prevent blood clots and support heart rhythm.
People on dialysis often have very low levels of these nutrients, which may increase their risk of heart problems. By taking fish oil, patients may be restoring a healthier balance in their bodies.
The results were striking. Patients who took fish oil had nearly half the number of serious heart-related events — including heart attacks, strokes, amputations due to poor circulation and deaths from heart disease — compared to those who took the placebo. Even patients who had already experienced a heart event saw benefits.
“While other heart protective medications have been shown to be beneficial in the general population, they haven’t consistently reduced cardiovascular events in the hemodialysis population,” says Dr. Lok. “Fish oil supplementation is a simple, well-tolerated intervention that could have a meaningful impact.”
The study found no increase in bleeding or other serious side effects, which was once a concern with omega-3 supplements. Blood tests showed that patients taking fish oil had higher levels of EPA and DHA, confirming that the capsules were absorbed and used by the body.
Further research is underway to better understand how fish oil works in patients receiving hemodialysis. For now, the findings suggest that daily supplementation of specific omega-3 could be a safe and effective way to protect the hearts of people on hemodialysis.
This work was supported by generous donors to UHN Foundation.
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