Serious cardiovascular events have a high incidence of morbidity and mortality in the haemodialysis population. Roughly two thirds of patients with end-stage kidney disease on dialysis have cardiovascular disease. Some studies suggest an inverse relationship between n-3 fatty acid levels in blood and risk of cardiovascular events. As these levels are known to be lower in haemodialysis patients, the investigators hypothesized that fish oil supplementation would lower the incidence of cardiovascular events compared to placebo. The trial involved 1228 participants on haemodialysis who were randomized to receive 4g of n-3 polyunsaturated fatty acids daily or placebo.

After 3.5 years of follow-up, the rate of serious CV events was significantly lower in the fish oil group, although the reduction in all-cause mortality did not reach statistical significance. Future trials to confirm efficacy will be helpful.

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