Many patients around the world rely on hemodialysis, a life-sustaining treatment that replaces part of the kidney’s function when the organ fails.

Despite this, patients receiving hemodialysis remain at high risk of cardiovascular disease, the leading cause of death in this population.

In the face of years of unsuccessful treatments to reduce cardiovascular risk in dialysis patients, recent clinical trials point to an unexpected contender: a daily fish oil supplement.

Recent clinical evidence is derived from the PISCES trial, a large international study investigating fish oil supplementation in patients undergoing maintenance hemodialysis.

The randomized, placebo-controlled trial followed 1,228 participants across 26 dialysis centers in Australia and Canada. The study was conducted by international researchers, including investigators at Monash Health and Monash University.

The trial was designed to evaluate whether daily supplementation with omega-3 fatty acids could reduce serious cardiovascular events in a population with consistently high risk and limited treatment options.

Participants who received fish oil supplementation experienced substantially fewer serious cardiovascular events than those given a placebo.

Patients assigned to four grams of fish oil per day, containing the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid, showed a 43% reduction in major cardiovascular outcomes over the following period.

These outcomes included fatal and nonfatal heart attacks, strokes, cardiac-related deaths and vascular complications resulting in amputation.

Additionally, researchers reported that participants in both groups followed the treatment regimen at similar levels and noted that the fish oil supplement was not associated with higher rates of side effects.

Researchers believe the benefits observed within this trial may be linked to the biological differences unique to patients receiving hemodialysis, particularly their lower baseline levels of omega-3 fatty acids.

“Dialysis patients typically have much lower levels of EPA and DHA than the general population,” Adjunct Professor Kevan Polkinghorne, a nephrologist at Monash Health and lead investigator for the Australian arm of the PISCES trial, told Science Daily.