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A daily fish oil supplement may reduce the risk of serious cardiovascular events for people receiving kidney dialysis treatment, an Australian study has found.
Researchers from Monash University found a 43 percent reduction in serious cardiovascular events—heart attack, stroke, cardiac death, and vascular-related amputations—when participants received four grams of fish oil containing EPA and DHA daily.
EPA and DHA are two of the “healthy fats,” (or n−3 polyunsaturated fatty acids) and are found in omega-3 fatty acids.
The study (pdf) was a multi-centre, double-blinded, randomised trial that assessed 1,228 haemodialysis patients across 26 sites in Australia and Canada between the period of November 2013 and July 2019. Around half (610) of the patients were assigned to the fish-oil group, while the other half (618) were assigned to the corn-oil placebo group.
Researchers found the rate of serious cardiovascular events was significantly lower in the fish-oil group than in the placebo group.
Kevan Polkinghorne, a nephrologist at Monash Health who led the Australian arm of the study, said patients on dialysis have a high risk of cardiovascular disease, and there are few treatments to reduce this risk.
“In a field where many trials have been negative, this is a significant finding.”
The Link Between Kidney and Cardiovascular Disease
Polkinghorne told The Epoch Times in an email that kidney disease and cardiovascular disease share many common risk factors.
“There are a number of shared risk factors for this—such as high blood pressure and diabetes—but also kidney disease itself contributes to that risk.
“Due to the unique nature of [these] risks, we need to find other therapies that help patients with kidney failure; hence why we did this study.”
Cardiovascular disease affects more than two-thirds of patients receiving dialysis, with the disease attributing to almost half of the deaths in dialysis patients.
Polkinghorne said he believes these findings are significant and show potential for new treatments for dialysis patients.
“I would hope that there will be other therapies that will become available in the future.”
How Do Fatty Acids Reduce Cardiovascular Disease?
The researchers noted that dialysis patients had lower levels of EPA and DHA than healthy people, which led them to suggest that providing supplements could be beneficial.
The connection between fatty acids and reduced cardiovascular risk was first documented in a 1971 Danish study. Researchers found that Inuit people living on Greenland’s west coast had a lower level of lipids (pre-β-lipoprotein and plasma-triglycerides) compared to Danish controls.
From the results, they established a link between a fishy diet and lowered cardiovascular risk. Since then, the findings have been replicated and the mechanisms better understood.
In 2022, the Frontiers journal published a review article discussing the health benefits of EPA and DHA. These include anti-inflammation, anti-thrombosis (reduces blood clots), antilipid (lowers cholesterol), and anti-arrhythmic (keeps heart rhythm stable) effects.
It explains the many genes and proteins that DHA and EPA regulate—it suppresses inflammation cells (CD4 and CD8) and increases expression of anti-inflammation genes.
Polkinghorne stressed these findings are specific to patients receiving dialysis.
“Our results only apply to patients with kidney failure on dialysis so [they] cannot be generalised to healthy people. I can’t use these results to recommend to healthy people,” he said.
The Future of Chronic Kidney Disease Treatment
According to The Lancet, chronic kidney disease (CKD) is projected to become the fifth leading cause of years of life lost globally. In Australia, CKD accounted for 1.1 percent of the total burden of disease. Burden of disease is a measure of the years of healthy life lost from living with or dying from disease and injury.
CKD is a progressive condition where the kidneys lose the ability to filter blood. In the early stages of disease (stage 1 to 3), most people feel normal. In the later stages of disease (stage 4 and 5), kidney disease can progress to kidney failure.
Advocacy groups, such as Kidney Health Australia, are looking at ways to end dialysis by 2050 and to change the diagnosis and treatment of kidney disease.
“Long term we would recommend treatment for patients on dialysis, and this does show that there are therapies that can work in this patient group,” Polkinghorne said.
According to the Australian Institute of Health and Welfare (AIHW), the number of people receiving dialysis in Australia doubled from 7,700 in 2003 to 15,500 in 2022, while hospitalisations for dialysis nearly tripled from 582,000 in 2000-01 to 1.7 million in 2021-22.
