Omega-3 Fatty Acids Reduce Cardiovascular Death in Dialysis Patients

Key Takeaways

• Kidney dialysis patients face extremely high mortality rates, with cardiovascular disease responsible for about 75% of deaths.
• Omega-3 fatty acids significantly reduced cardiovascular death in dialysis patients in a 3.5-year clinical study.
• Participants taking 2.4 g of omega-3s (EPA:DHA ratio of 2:1) experienced a 45% reduction in cardiovascular death and 37% fewer strokes.
• Omega-3 fatty acids rapidly incorporate into cell membranes, helping stabilize arterial plaques and reduce inflammation.
• Achieving an AA/EPA ratio below 2 provides stronger protection against plaque rupture and cardiovascular events.
• Omega-3 intake works best when combined with the Zone Diet, which activates AMPK—the master regulator of metabolism.
• Metabolic Engineering® combines diet, omega-3s, and polyphenols to reduce systemic inflammation and improve long-term health.

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Can Omega-3 Fatty Acids Reduce Mortality in Dialysis Patients?

Quick Answer

Yes. A clinical study of more than 1,200 kidney dialysis patients found that 2.4 grams of omega-3 fatty acids daily reduced cardiovascular death by 45% and lowered stroke risk by 37% over 3.5 years. Omega-3 fatty acids help stabilize arterial plaques and reduce inflammation, both of which are major drivers of cardiovascular disease in dialysis patients.

Why Cardiovascular Disease Is So Dangerous for Dialysis Patients

Going on kidney dialysis is essentially a death sentence, as the death rate is about 20 percent per year.  Of those deaths, accelerated cardiovascular disease accounts for 75% of the mortality.  This rate of cardiovascular mortality is about 20 times as high as that of the general population (1). 

What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2).  It would be considered a “wonder drug,” and billions could be made overnight for such a drug.  Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids.  In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3). 

What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2).  It would be considered a “wonder drug,” and billions could be made overnight for such a drug.  Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids.  In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3). 

The Clinical Study on Omega-3 Fatty Acids and Dialysis

What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2).  It would be considered a “wonder drug,” and billions could be made overnight for such a drug.  Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids.  In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3). 

What if a “drug” could reduce cardiovascular death by 45 percent as well as reduce fatal and non-fatal stroke by 37 percent over a 3.5-year period (2).  It would be considered a “wonder drug,” and billions could be made overnight for such a drug.  Fortunately, it is not a drug, but an adequate intake of omega-3 fatty acids.  In particular, the exact dosage of total omega-3 fatty acids, using the same EPA-to-DHA ratio I have recommended for the past 24 years since I wrote The OmegaRx Zone (3). 

The Clinical Study on Omega-3 Fatty Acids and Dialysis

This was a well-conducted study with more than 1,200 participants.  More than half were taking statins, and nearly 25 percent were taking anti-coagulant drugs.  Those in the active group received 2.4 grams of omega-3 fatty acids, with a 2:1 EPA: DHA ratio.  Those in the placebo group received placebo capsules rich in omega-6 fatty acids. 

The differences in cardiovascular events between the two groups were evident as early as three months. This time corresponded to the rate of EPA incorporation into plasma phospholipids and likely also reflected its incorporation into the arterial cell membranes.  What about bleeding, since both groups were using the same levels of anti-coagulant drugs?  Those on the placebo had a 1.6 times greater risk of bleeding than those taking the omega-3 fatty acids.  

Why the AA/EPA Ratio Matters

Of course, this study raises the question, could even better results be obtained by taking higher doses of omega-3 fatty acids? The answer is yes, because ideally you want your AA/EPA ratio to be less than 2 to reduce the rupture of an existing atherosclerotic plaque, which is the primary cause of cardiovascular events (4,5).  To reach that level usually requires a higher intake of omega-3 fatty acids.

However, keep in mind that adequate intake of omega-3 fatty acids is only one component of Metabolic Engineering®.  An even more striking impact can be achieved by following the Zone diet to increase AMPK activity, the master regulator of metabolism. 

Combining the Zone diet to increase AMPK activity with adequate intake of omega-3 fatty acids dramatically enhances your ability to reduce inflammation in every organ of the body.  What that means to you is a longer and better life.    

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FAQ  

Can omega-3 fatty acids help dialysis patients live longer?

Yes. Clinical research shows omega-3 fatty acids significantly reduce cardiovascular mortality and stroke risk in dialysis patients.

What dose of omega-3 fatty acids was used in the dialysis study?

Participants received 2.4 grams per day of omega-3 fatty acids with a 2:1 EPA-to-DHA ratio.

Why are dialysis patients at high risk of cardiovascular disease?

Chronic inflammation and metabolic dysfunction significantly increase cardiovascular risk in dialysis patients.

What is the AA/EPA ratio?

The AA/EPA ratio measures the balance between pro-inflammatory and anti-inflammatory fatty acids in the body. Lower ratios indicate reduced inflammation.

How does the Zone Diet improve metabolic health?

The Zone Diet activates AMPK, the master regulator of metabolism, which improves energy regulation and reduces inflammation.

References

• 1.  Foley RN, Parfrey PS, Sarnak MJ.  Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 32(5 Suppl 3): S112-119 (1998). doi: 10.1053/ajkd.1998.v32.pm9820470. PMID: 9820470. 
• 2. Lok CE, Farkouh M, Hemmelgarn BR, Moist LM, Polkinghorne KR, Tomlinson G, Tam P, Tonelli M, Udell JA; PISCES Investigators.  Fish-oil supplementation and cardiovascular events in patients receiving hemodialysis. N Engl J Med. 2025 Nov 7. doi: 10.1056/NEJMoa2513032. 
• 3.  Sears B.  The OmegaRx Zone. Regan Books.  New York, NY (2001)
• 4.  Hasegawa T, Otsuka K, Iguchi T, Matsumoto K, Ehara S, Nakata S, Nishimura S, Kataoka T, Shimada K, Yoshiyama M. Serum n-3 to n-6 polyunsaturated fatty acids ratio correlates with coronary plaque vulnerability:  An optical coherence tomography study.  Heart Vessels. 29:596-602 (2014). doi: 10.1007/s00380-013-0404-4. 
• 5.  Sekimoto T, Koba S, Mori H, Arai T, Yamamoto MH, Mizukami T, Matsukawa N, Sakai R, Yokota Y, Sato S, Tanaka H, Masaki R, Oishi Y, Ogura K, Arai K, Nomura K, Sakai K, Tsujita H, Kondo S, Tsukamoto S, Suzuki H, Shinke T.  Association between eicosapentaenoic acid to arachidonic acid ratio and characteristics of plaque rupture. J Atheroscler Thromb. 30:1687-1702 (2023). doi: 10.5551/jat.63806.