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A large international clinical trial indicates that a simple daily fish oil supplement can significantly reduce serious cardiovascular events in people receiving hemodialysis for kidney failure. The finding points to a low-cost, widely available therapy that may change how clinicians approach cardiovascular risk in this high-risk group.
A large international clinical trial suggests that a daily fish oil supplement may markedly lower the risk of serious cardiovascular events in people undergoing dialysis for kidney failure.
Big trial, clear results
The PISCES trial enrolled 1,228 people treated at 26 dialysis centres across Australia and Canada. Participants received either four grams of fish oil daily—providing the omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid)—or a placebo, and were followed for major cardiovascular outcomes. The team reported a 43% lower rate of major cardiovascular events in the fish oil group versus placebo. Measured outcomes included heart attack, stroke, death from cardiac causes and amputations related to vascular disease.
The trial was presented at the American Society of Nephrology Kidney Week 2025 and published simultaneously in The New England Journal of Medicine, giving the findings high visibility in both clinical and public forums.
Why people on dialysis may benefit most
Cardiovascular disease is the leading cause of death among people with kidney failure on hemodialysis. Standard preventive therapies used in the general population are often less effective or harder to apply in dialysis patients, who carry a uniquely high burden of vascular inflammation, altered lipid profiles and metabolic stress.
Investigators led in Australia by Adjunct Professor Kevan Polkinghorne noted that dialysis patients typically have much lower circulating levels of EPA and DHA than the general population. That deficit could make them especially responsive to supplementation. The observed 43% reduction in major events is unusually large for a single adjunctive therapy in this field, where many past trials have failed to show benefit.
Clinical implications and next steps
If replicated and validated in guideline reviews, these results could prompt nephrology services to consider routine fish oil supplementation for patients on hemodialysis. Important practical questions remain: the optimal dose and formulation, long-term safety and interactions with other medications (for example, antiplatelet or anticoagulant drugs), and whether benefits extend to different dialysis populations or those with earlier stages of kidney disease.
Clinicians should not generalise the trial outcomes to healthy people or to patient groups that were not enrolled in PISCES. Patients interested in starting omega-3 supplements should discuss the decision with their nephrology team so that dosing, product quality and individual risk factors are considered.
Implications for research and practice
This study opens new lines of inquiry into the mechanisms by which EPA and DHA reduce vascular events in uraemic conditions, and it highlights the importance of addressing nutritional deficiencies in specialised populations. Large-scale adoption will depend on confirmatory studies, regulatory and guideline assessments, and practical pathways for safe supplementation within dialysis services.
Source: scitechdaily
Comments
skyspin
Is this even true? 4g fish oil daily seems simple but 43% fewer events is huge. Sample skewed? Bleeding risk with anticoagulants, or just hype?
labcore
Wow, a 43% drop in major CV events? If this holds up it could change dialysis care. Hope they check long term safety, drug interactions and product quality. omg promising
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