Table of Contents
November 08, 2025
2 min read
Key takeaways:
The fish oil group reported a significantly lower rate of CV events vs. placebo.
Future research should explore mechanisms behind omega-3 supplements for kidney disease, according to researchers.
HOUSTON — Fish oil supplementation showed efficacy in reducing risks for cardiovascular events for patients on dialysis, according to data from the PISCES trial presented at ASN Kidney Week.
Use of omega-3 supplements, a type of polyunsaturated fatty acids that includes eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), has been explored for potential CV health benefits, according to Charmaine E. Lok, MD, MSc, FRCPC, professor of medicine at the University of Toronto and senior scientist at the Toronto General Hospital Research Institute. However, supplementation in a patient population on hemodialysis has not been established, despite patients on dialysis having a 20 times greater risk for CV death, according to Lok.
Data derived from Lok CE. FR-OR082. Presented at: ASN Kidney Week; Nov. 5-9, 2025; Houston.
“There really is no recommendation in terms of should you take fish oil supplementation or not, particularly in capsule form,” Lok said during a press briefing at ASN Kidney Week.
To test the efficacy of fish oil supplements for the dialysis population, Lok and colleagues conducted a double-blind, randomized, placebo-controlled trial at 26 sites across Canada and Australia from 2013 to 2019.
Results were simultaneously published in The New England Journal of Medicine.
Patients on hemodialysis were randomly assigned into two groups: 610 patients (mean age, 64.1 years; 62.2% men; 40% white) received 4 g steam-deodorized, citrus-flavored omega-3 fatty acids, and 618 patients (n = 618; mean age, 64.5 years; 63.1% men; 39.5% white) received citrus-flavored corn oil placebo. The fish oil group received four 1 g capsules containing 1.6 g EPA and 0.8 g DHA.
The primary outcome focused on a composite of severe CV events — myocardial infarction resulting in amputation, stroke, peripheral vascular disease and CVD death. The secondary endpoints were noncardiac cause death, individual CV event rates and all-cause mortality.
After a follow-up period of 3.5 years, the fish oil group had a significantly lower rate of CV events compared with the placebo group (0.31 per 1,000 patient-days vs. 0.61; HR = 0.57; 95% CI, 0.47-0.7).
Including noncardiac causes of death, the fish oil group had a lower mortality rate compared with placebo (HR = 0.77; 95% CI, 0.65-0.9).
For individual risk factors, the fish oil group had reduced risks for CV death (HR = 0.55; 95% CI, 0.4-0.75), myocardial infarction (HR = 0.56; 95% CI, 0.4-0.8), peripheral vascular disease (HR = 0.57; 95% CI, 0.38-0.86), stroke (HR = 0.37; 95% CI, 0.18-0.76) and all-cause mortality (HR = 0.73; 95% CI, 0.61-0.87).
The data show daily fish oil supplementation reduced the risk for CVD for patients on hemodialysis. According to Lok, understanding the mechanisms behind supplementation can help to explore its benefits for patients with kidney disease.
Charmaine E. Lok
“What we really need to do is try to look into the mechanisms of action,” Lok told Healio. “We have a lot of data, and I think there’s a lot of work for us to unravel the effects and why they occurred.”
For more information:
Charmaine E. Lok, MD, MSc, FRCPC, can be reached at nephrology@healio.com.
Sources/Disclosures
Source:
Lok CE. FR-OR082. Presented at: ASN Kidney Week; Nov. 5-9, 2025; Houston.
Reference:
Disclosures:
Lok reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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