Omega-3s Reduce Cardiovascular Events in Dialysis Patients – Study

A daily dose of omega-3 fatty acids may significantly reduce the risk of cardiovascular events in patients undergoing hemodialysis, a new study reveals. The research, conducted across Canada and Australia, found a nearly 40% reduction in serious cardiovascular incidents among those receiving the supplement.

Cardiovascular disease is the leading cause of death for individuals on hemodialysis, a life-sustaining treatment for kidney failure. This study offers a promising avenue for improving outcomes in this vulnerable population, where survival rates are lower than in the general public.

The multi-center trial, involving approximately 1230 adult patients, tracked outcomes over 3.5 years. Participants were randomly assigned to receive either four grams of omega-3 fatty acids daily or a placebo. Researchers assessed a range of cardiovascular events, including sudden cardiac death, heart attack, stroke, and limb amputation due to peripheral vascular disease.

“The incidence of cardiovascular events in participants taking fatty acids who had already experienced a cardiovascular event was equivalent to the incidence in participants in the control group who had never experienced such an event,” researchers reported in the New England Journal of Medicine.

Dr. Rita Suri, head of the division of nephrology at the McGill University Health Centre and a researcher at the MUHC Research Institute, emphasized the significance of the findings. “Patients undergoing hemodialysis have a lower survival rate than the general population, and most of them die from heart disease,” she said. “The nephrology community has been striving for decades to find ways to improve the survival of these patients. This is one of the first clinical trials to have such a dramatic effect.”

The study’s primary endpoint was a composite of all major cardiovascular events, both fatal and non-fatal. Secondary endpoints included non-cardiac causes of death, individual components of the primary endpoint, and the first cardiovascular event or death from any cause.

Researchers hypothesize that the protective effect may be particularly pronounced in hemodialysis patients due to their typically low levels of omega-3 fatty acids. They also noted that hemodialysis patients have a unique metabolic, rheological, inflammatory, and cardiovascular profile that can be worsened by the treatment itself.

“Individuals on maintenance hemodialysis experience a distinct metabolic, rheological, inflammatory, and cardiovascular profile that can be exacerbated by the treatment itself,” the study authors wrote. The risk of cardiovascular events is up to twenty times higher in hemodialysis patients compared to the general population, according to Dr. Suri.

“Many of these patients have the same common risk factors for heart disease as the general population, such as diabetes, high blood pressure, and smoking,” Dr. Suri explained. “But dialysis patients have additional risk factors that can contribute to a high risk of death, namely a high burden of what are called inflammatory diseases.”

When the kidneys don’t function efficiently, inflammatory hormones surge, potentially contributing to cardiovascular disease. Hemodialysis itself can also cause irregular heart rhythms, which can be life-threatening.

Despite the encouraging results, Dr. Suri cautioned against immediately recommending omega-3 supplements to all hemodialysis patients. She noted uncertainty about whether over-the-counter products are comparable to those used in the study and highlighted the cost barrier, as these supplements are not currently covered by provincial health insurance plans or private insurers.

“However,” Dr. Suri concluded, “it is very encouraging to know that we may now have the opportunity to offer this treatment to our patients to prevent cardiovascular events and improve their overall health.”