Effect of Fish Oil on Hemodialysis Graft Patency and Cardiovascular Events

A recently published study determined the effect of fish oil on synthetic hemodialysis graft patency and cardiovascular events.¹ This randomized, doubleblind, controlled clinical trial was conducted at 15 North American dialysis centers from November 2003 through December 2010. Study subjects (n = 201) were adults with stage 5 chronic kidney disease (50% women, 63% white, 53% with diabetes).

Subjects were randomized to receive fish oil capsules (4 g/day) or matching placebo on day 7 after graft creation with follow-up for 12 months after graft creation. The primary end point was the proportion of participants experiencing graft thrombosis or radiologic or surgical intervention during the follow-up period.

Study results showed that the risk of the primary end point did not differ between treatment groups (48% for the fish oil group vs 62% for the placebo group; relative risk, 0.78; 95% confidence interval [CI], 0.60-1.03; P = .06). The rate of graft failure was lower in the fish oil group (3.43 vs 5.95 per 1000 access days; incidence rate ratio, 0.58; 95% CI, 0.44-0.75; P <.001).

Investigators concluded that among patients with new hemodialysis grafts, daily fish oil did not decrease the proportion of grafts with loss of native patency within 12 months. Although fish oil improved some relevant secondary outcomes, more studies are needed to confirm a benefit regarding cardiovascular events.

Dr. Reed received her doctor of pharmacy degree from the University of the Sciences in Philadelphia, Pennsylvania, and currently works as a medical editor in the greater Philadelphia area.

References

1. Ebbeling CB, Swain JF, Feldman HA, et al. Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA. 2012;307(24):2627-2634.

2. Jakicic JM, Tate DF, Lang W, et al. Effect of a stepped-care intervention approach on weight loss in adults: a randomized clinical trial. JAMA. 2012;307(24):2617-2626.

3. Mohr DC, Ho J, Duffecy J, et al. Effect of telephone-administered vs face-to-face cognitive behavioral therapy on adherence to therapy and depression outcomes among primary care patients: a randomized trial. JAMA. 2012;307(21):2278-2285.