Abstract: FR-OR082
Protection Against Incidences of Serious Cardiovascular Events Study with Daily Fish Oil Supplementation in Patients on Dialysis (PISCES)
Session Information
- High-Impact Clinical Trials - 1
November 07, 2025 | Location: Hall A, Convention Center
Abstract Time: 10:30 AM - 10:40 AM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Lok, Charmaine E., University Health Network, Toronto, Ontario, Canada
- Hemmelgarn, Brenda, University of Alberta, Edmonton, Alberta, Canada
- Moist, Louise M., Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
- Polkinghorne, Kevan, Monash University, Melbourne, Victoria, Australia
- Tomlinson, George, University of Toronto, Toronto, Ontario, Canada
- Tam, Paul Y., Scarborough Health Network, Scarborough, Ontario, Canada
- Tonelli, Marcello, University of Calgary, Calgary, Alberta, Canada
Group or Team Name
- For the PISCES Investigators.
Background
Cardiovascular (CV) events occur frequently and is the leading cause of mortality in patients receiving maintenance hemodialysis (HD), yet effective preventive therapies remain limited. Omega-3 polyunsaturated fatty acids (n-3 PUFA)- eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have shown potential CV benefits in the general population, although their efficacy in the HD population is uncertain.
Methods
PISCES was a multicenter double-blind placebo-controlled RCT evaluating the effect of daily oral supplementation with 4 g of n-3 PUFA (1.6 g EPA, 0.8 g DHA) vs placebo in 1228 adults on maintenance HD (26 sites) x 3.5 years. The primary endpoint was the rate of all serious CV events (CV death, non-fatal myocardial infarction, stroke, peripheral vascular disease requiring amputation). Secondary outcomes included the primary outcome plus all-cause mortality and individual components of the primary outcome.
Results
The rate of the primary outcome was significantly lower in the n-3 PUFA group (0.31/1000 days) compared to placebo (0.61/1000 days) (Fig 1); HR 0.57 (95% CI: 0.47-0.70), p<0.0001 (Fig 2). The rate of the secondary outcome of CV events and all-cause mortality was significantly reduced (HR 0.77; 95% CI:0.65–0.90; p<0.0001). Benefits were consistent among those with (HR 0.50; 95% CI: 0.37-0.67] and without (HR 0.55; 95% CI: 0.40-0.76; p < 0.000) prior CV events. Each component of the primary outcome occured less frequently in n-3 PUFA group (Fig 2). There were no safety signals.
Conclusion
The rate of serious CV events was significantly lower in patients on maintenance HD who received daily n-3 PUFA compared with placebo.
Funding
- Other NIH Support – In Kind contribution from DSM (previously Ocean Nutrition Canada)