A large international randomized trial found that 4 grams a day of omega-3 fish oil was associated with a 43% lower rate of serious cardiovascular events among adults receiving maintenance hemodialysis. The PISCES study enrolled 1,228 participants at 26 sites in Australia and Canada; results were presented at the American Society of Nephrology’s Kidney Week 2025 and published in The New England Journal of Medicine.
The PISCES trial tested whether daily omega-3 supplementation could reduce major cardiovascular complications in people receiving hemodialysis for kidney failure, a group at especially high risk of heart disease.
According to Monash University, the study enrolled 1,228 dialysis patients across 26 sites in Australia and Canada and compared four grams per day of fish oil—containing the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—with placebo. Patients assigned to fish oil experienced a 43% lower rate of serious cardiovascular events, a composite that included heart attack, stroke, cardiac death, and vascular-related amputations.
Adjunct Professor Kevan Polkinghorne, a nephrologist at Monash Health and an adjunct in Monash University’s School of Clinical Sciences, led the Australian portion of the trial. In remarks distributed by Monash University, he said dialysis patients face “extremely high cardiovascular risk” and that few therapies have been shown to reduce that risk. He added that patients on dialysis “typically have much lower levels of EPA and DHA than the general population,” which he suggested may help explain the size of the benefit.
Polkinghorne also cautioned that the findings are specific to people receiving hemodialysis and should not be generalized to healthy individuals or other patient groups.
Monash University said the Australian arm was supported by Australia’s National Health and Medical Research Council, with trial coordination by the Australasian Kidney Trials Network. About 200 participants were enrolled in Australia, including 44 treated at Monash Health. International leadership, Monash University said, came from Professor Charmaine Lok and colleagues at the University Health Network in Toronto and the University of Calgary.
The trial’s results were presented at ASN Kidney Week 2025 and published in The New England Journal of Medicine in January 2026.
