Fish oil supplementation markedly lowered heart and vascular complications in people receiving hemodialysis, according to a major international trial.
A daily fish oil supplement has been found to sharply lower the risk of serious cardiovascular complications in people undergoing dialysis for kidney failure. The evidence comes from a large international clinical trial jointly led in Australia by Monash Health and the School of Clinical Sciences at Monash University.
Known as the PISCES trial, the study followed 1,228 patients treated at 26 dialysis centers across Australia and Canada. The findings were presented at the American Society of Nephrology Kidney Week 2025 and released at the same time in The New England Journal of Medicine.
Why dialysis patients may benefit most
Patients who took four grams of fish oil each day, providing the active compounds EPA and DHA, had a 43 per cent lower rate of major cardiovascular events than those given a placebo. These outcomes included heart attacks, strokes, deaths from cardiac causes, and amputations linked to vascular disease.
Adjunct Professor Kevan Polkinghorne, a nephrologist at Monash Health and adjunct in the School of Clinical Sciences, led the Australian arm of the study.
“Patients on dialysis have extremely high cardiovascular risk, and very few therapies have been shown to reduce that risk,” Professor Polkinghorne said. “In a field where many trials have been negative, this is a significant finding.
“Dialysis patients typically have much lower levels of EPA and DHA than the general population. This may help explain the magnitude of benefit observed in this group.”
Professor Polkinghorne noted that the findings are specific to people receiving hemodialysis for kidney failure and should not be applied to healthy individuals or other patient groups.
Reference: “Fish-Oil Supplementation and Cardiovascular Events in Patients Receiving Hemodialysis” by Charmaine E. Lok, Michael Farkouh, Brenda R. Hemmelgarn, Louise M. Moist, Kevan R. Polkinghorne, George Tomlinson, Paul Tam, Marcello Tonelli and Jacob A. Udell, 6 November 2025, New England Journal of Medicine.
Disclosure: Central trial coordination was provided by the Australasian Kidney Trials Network (AKTN). Around 200 Australian participants contributed to the study, including 44 treated at Monash Health.
The Australian arm was supported by the National Health and Medical Research Council (NHMRC).
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