Anti-inflammatory effects and safety of omega-3 fatty acids in haemodialysis: A systematic review and meta-analysis
Blair C, Slee A, McKeaveney C, Maxwell AP, Awan F, Brown M, Davenport A, Fogarty D, Fouque D, Johnston W, Kalantar-Zadeh K, Mullan R, Noble H, Porter S, Seres DS, Shields J, Swaine I, Witham M, Reid J
Clinical nutrition ESPEN · 0 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Mechanisms only
Who paid for it
- Funding
- Independent funding
- Government
- National Institute for Health and Care Research
- Government
- NIHR Newcastle Biomedical Research Centre
Based on 2 listed funder(s).
Publication
- Published
- 2026-02-13 · Clin Nutr ESPEN · vol. 72 · p. 102957
- Publisher
- Elsevier BV
- Cited
- 1 citation · more than 83% of similar papers · 2.8× the field average
- References
- 58 works
- Access
- Open access (repository copy) · CC-BY
- Research areas
- Fatty Acid Research and Health · Dialysis and Renal Disease Management · Parathyroid Disorders and Treatments
- Keywords
- Triglyceride, Ethyl ester, Fatty acid, Clinical trial, Triglycerides blood
- MeSH
- humans, inflammation, fatty acids, omega-3, docosahexaenoic acids, eicosapentaenoic acid, c-reactive protein, anti-inflammatory agents, renal dialysis, dietary supplements
19 authors
From GB, FR, US
- Carolyn Blair · correspondingQueen's University Belfast
- Adrian J. Slee · correspondingUniversity College Hospital; University College London
- Clare McKeaveney · correspondingQueen's University Belfast
- A. P. Maxwell · correspondingQueen's University Belfast
- Faizan Awan · corresponding
- Malcolm Brown · correspondingUniversity of Ulster
Abstract
Introduction
Evidence on the anti-inflammatory effects and safety of omega-3 fatty acid supplementation in haemodialysis (HD) patients remains limited, particularly regarding the influence of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) dose, composition, and source.
Methods
We searched PubMed (n = 345), CENTRAL (n = 148) and EMBASE (n = 706) to July 2025. Studies were screened using Covidence, risk of bias was assessed using the Cochrane ROB 1 tool, and analyses were conducted in Review Manager 9.5.1. Only trials reporting C-reactive protein (CRP) were included. Pre-planned subgroup analyses examined formulation type, total daily dose, active ingredient dose, and DHA:EPA composition. Random-effects models were used to generate pooled standardised mean differences (SMDs), with heterogeneity assessed using I2. A sensitivity analysis excluded studies at high risk of bias. The protocol is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/JCBHN).
Results
Thirteen studies (n = 678) were included (12 in meta-analyses). Two studies were judged high risk of bias, one unclear, and the remainder low risk. Adverse events were poorly reported: eight trials did not report any events, while five described only mild, transient effects (e.g., diarrhoea). Omega-3 fatty acids reduced CRP more than comparators across triglyceride formulations (SMD -0.62, 95 % CI -1.22 to -0.03; P = 0.04, I2 = 74 %); in the 2 = 29 %); and in the 2 = 31 %). No statistically significant differences were observed between subgroups. Sensitivity analyses did not materially change the results.
Conclusion
A daily dose <2000 mg of omega-3 fatty acids in natural triglyceride form appears more effective than synthetic ethyl ester formulations for lowering CRP in HD patients. Larger, high-quality trials are required to confirm therapeutic benefit, determine optimal dosing, and clarify the ideal EPA:DHA composition for this population.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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