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Life Extension Newsletter
Trial finds fish oil protects against fatal and nonfatal cardiovascular events in kidney disease patients undergoing dialysis
Findings from a trial reported November 7, 2025, in the New England Journal of Medicine revealed a significantly lower risk of serious cardiovascular events among individuals undergoing kidney dialysis who received fish oil compared with those who received a placebo.1 Cardiovascular events evaluated in the trial included sudden and nonsudden cardiac death, fatal and nonfatal heart attack, fatal and nonfatal stroke, and peripheral vascular disease leading to amputation.
During a 3.5-year follow-up period, the rate of serious cardiovascular events was 43% lower among participants who received fish oil in comparison with those who received a placebo. Participants who received fish oil had a 44% lower risk of fatal and nonfatal heart attack, a 43% lower risk of peripheral vascular disease leading to amputation, a 63% lower risk of fatal and nonfatal stroke, and a 27% lower risk of a first cardiovascular event or death from any cause compared with the placebo. Noncardiac deaths were 33% lower and cardiac deaths were 45% lower among those who received fish oil.
“Cardiovascular disease affects more than two-thirds of persons receiving hemodialysis and accounts for more than 75% of the associated deaths; cardiovascular mortality is 20 times as high as that in the general population, a finding that highlights the importance of effective cardiovascular management,” authors Charmaine E. Lok, MD, of the University of Toronto and colleagues remarked. “However, these high-risk patients receiving maintenance hemodialysis are challenged by both traditional and nontraditional cardiovascular risk factors, and there are few proven medical interventions for the prevention of cardiovascular events in this population.”
The double-blind, randomized, placebo-controlled Protection against Incidences of Serious Cardiovascular Events Study (PISCES) included 610 dialysis patients who received fish oil that provided 4 grams of omega-3 polyunsaturated fatty acids (including 1.6 grams of EPA and 0.8 grams DHA) per day and 618 participants who received a daily placebo for 3.5 years.
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Apply What You’ve Learned: Chronic kidney disease
- Chronic kidney disease, as opposed to acute kidney disease, is characterized by abnormalities in kidney function or structure of a duration of at least three months which affect health. While over one in seven adults in the U.S. have chronic kidney disease, as many as nine in ten people with the disease don’t know they have it. A third of those with severe kidney disease remain unaware of the disease’s presence.2
- Cardiovascular-kidney-metabolic (CKM) syndrome is a recently recognized disorder that describes the connections between obesity, diabetes, chronic kidney disease, and cardiovascular disease (which includes coronary heart disease, stroke and other conditions).3
- Testing for kidney values should be a part of everyone’s routine yearly blood work. Uric acid, blood urea nitrogen (BUN) creatinine, BUN/creatinine ratio and estimated glomerular filtration rate (eGFR) are commonly assessed values that are used to evaluate kidney function.
- Adopting a Mediterranean or Dietary Approaches to Stop Hypertension (DASH) diet may help protect against the development of chronic kidney disease.4,5 Certain nutrients may also be helpful to support kidney health, including grape seed extract, the antioxidants selenium and vitamin E, the herb Terminalia bellerica and more.6–8
References
- Lok CE, Farkouh M, Hemmelgarn BR, et al. Fish-oil supplementation and cardiovascular events in patients receiving hemodialysis. N Engl J Med. 2025 Nov 7. doi: 10.1056/NEJMoa2513032.
- Chronic kidney disease in the United States. U.S. Centers for Disease Control and Prevention. 2024 May 15. https://www.cdc.gov/kidney-disease/php/data-research/ Accessed 2025 Nov 14
- Ndumele CE, Rangaswami J, Chow SL, et al. Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association. Circulation. 2023 Nov 14;148(20):1606-1635. doi: 10.1161/CIR.0000000000001184.
- Rebholz CM, Crews DC, Grams ME, et al. DASH Study (Dietary Approaches to Stop Hypertension) diet and risk of subsequent kidney disease. 2016 Dec;68(6):853-861. doi: 10.1053/j.ajkd.2016.05.019.
- Hu EA, Coresh J, Anderson CAM, et al. Adherence to Healthy Dietary Patterns and Risk of CKD Progression and All-Cause Mortality: Findings From the CRIC (Chronic Renal Insufficiency Cohort Study). Am J Kidney Dis. 2021 Feb;77(2):235-244. doi: 10.1053/j.ajkd.2020.04.019.
- Turki K, Charradi, Boukhalfa H, et al. Grape seed powder improves renal failure of chronic kidney disease patients. EXCLI J. 2016 Jun 27:15:424-433. doi: 10.17179/excli2016-363.
- Zitouni K, Steyn MRCP, Lyka E, et al. Derepression of glomerular filtration, renal blood flow and antioxidant defence in patients with type 2 diabetes at high-risk of cardiorenal disease. Free Radic Biol Med. Dec 2020;161:283-289. doi:10.1016/j.freeradbiomed.2020.10.005
- Usharani P, Nutalapati C, Pokuri VK, et al. A randomized, double-blind, placebo-, and positive-controlled clinical pilot study to evaluate the efficacy and tolerability of standardized aqueous extracts of Terminalia chebula and Terminalia bellerica in subjects with hyperuricemia. Clin Pharmacol. 2016 Jun 22:8:51-9. doi: 10.2147/CPAA.S100521.
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