Hemodialysis patients with end-stage renal illness had disproportionately high rates of thrombosis, chronic systemic inflammation, and cardiovascular death. The complicated lipid dysregulation and oxidative stress that the dialysis procedure itself exacerbates are often difficult to manage with conventional pharmaceutical therapies. As a result, omega-3 polyunsaturated fatty acids, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), have become a very promising supplemental treatment.
Targeted Omega-3 supplementation has been shown to help maintain endothelial function, lower systemic inflammatory indicators including C-reactive protein, and dramatically cut blood triglyceride levels. Most importantly, these fatty acids have anti-arrhythmic qualities that may reduce the occurrence of sudden cardiac death, which is a major cause of death in this susceptible population. To improve nephrology dietary guidelines, reduce hemodialysis-related problems, and ultimately improve long-term cardiovascular outcomes and quality of life for these patients, it is critical to assess the complex clinical impact of Omega-3 fatty acids. As a result, this study assessed how n-3 PUFA supplementation affected hemodialysis patients.
Through November 2025, randomized controlled studies (RCTs) comparing n-3 PUFAs with placebo in adult hemodialysis patients were found using PubMed, Embase, and CENTRAL. A random-effects model was used to pool the data, which were then presented as mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CI). Subgroup analyses were carried out according to age, follow-up, diabetes, and hypertension.
All-cause mortality was not substantially decreased by n-3 PUFA supplementation (RR = 0.93; 95% CI 0.80–1.08; p = 0.33). Conversely, there was a substantial decrease in cardiovascular mortality (RR = 0.55; 95% CI 0.42–0.71; p < 0.001) and fewer events due to vascular access (RR = 0.83; 95% CI 0.73–0.95; p = 0.005). Both fatal and non-fatal MI showed substantial impacts (RR = 0.50; 95% CI 0.36–0.68; p < 0.001).
Overall, in hemodialysis patients, n-3 PUFA supplementation dramatically lowers cardiovascular mortality, myocardial infarction, and vascular access events without changing all-cause mortality. The prospective use of omega-3 PUFAs as an additional cardioprotective treatment in the hemodialysis population is supported by these data.
Source:
Ahmed Jilani, H. B., Baig, B. M., Rasool, A., Ibrahim, M., Khalid, A., Rizvi, M. S., Daniyal, S. M., Jalal, A. A., Arfan, A., Samad, Z. A., Saad, M., Rao, H., Jalaluddin, J., & Jabarkhil, R. (2026). Impact of OMEGA-3 fatty acid in patients undergoing hemodialysis: a systematic review and meta-analysis. BMC Nephrology. https://doi.org/10.1186/s12882-026-05140-4
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