The Lure of PISCES: Polyunsaturated Fatty Acid Levels as Novel Cardiovascular Risk Factors in Hemodialysis Patients

Certificate Output Instructions

For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".

To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".

Presented the abstract " "
(Abstract co-author(s): )

Back

E-Poster Presentation

During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.

Preparing your E-Poster

Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.

E-Poster Submission Deadline

Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.

E-Poster Format Requirements

PDF file
Layout: Portrait (vertical orientation)
One page only (Dim A4: 210 x 297mm or PPT)
E-Poster can be prepared in PowerPoint (one (1) PowerPoint slide) but must be saved and submitted as PDF file.
File Size: Maximum file size is 2 Megabytes (2 MB)
No hyperlinks, animated images, animations, and slide transitions
Language: English
Include your abstract number
E-posters can include QR codes, tables and photos

E-Poster

Abstract Title *

The Lure of PISCES: Polyunsaturated Fatty Acid Levels as Novel Cardiovascular Risk Factors in Hemodialysis Patients

Please follow the instructions below to input your abstract title.

Abstract titles should be brief and reflect the content of the abstract.

The title will not be accepted if it exceeds 25 words.
Type in CAPITAL LETTERS.
Lowercase may be used for abbreviations only, for example, mRNA.

Co-author 1

George Tomlinson george.tomlinson@utoronto.ca University Health Network Medicine Toronto Canada -

Co-author 2

Kevan Polkinghorne kevan.polkinghorne@monash.edu Monash University Nephrology Monash Australia -

Co-author 3

David W. L. Ma davidma@uoguelph.ca University of Guelph Human Health Sciences Guelph Canada -

Co-author 4

Charmaine E. Lok charmaine.lok@uhn.ca University Health Network Nephrology Toronto Canada *

Co-author 5

PISCES Investigators pisces88rct@gmail.com University Health Network Nephrology Toronto Canada -

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Persons treated with maintenance hemodialysis (HD) are at high risk of serious cardiovascular (CV) events. We hypothesized that low levels of omega-3 polyunsaturated fatty acids (n-3 PUFA; eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and high levels of omega-6 fatty acids (arachidonic acids [AA]) in patients treated with HD are novel risk factors for CV events.

Methods

PISCES was a 1:1 double-blinded multicentre RCT that evaluated the effect of fish oil vs. placebo supplementation on CV events in 1228 HD patients. CV events included fatal and nonfatal myocardial infarction, fatal and nonfatal stroke, peripheral vascular disease requiring amputation, and cardiac death. A randomly selected subset of participants (n=330) had blood drawn at 3 months to evaluate the association between percentage of EPA, DHA and AA in fatty acids and the rate of CV events using negative binomial models.

Results

The overall ranges of fatty acids (%) were EPA-0.2-7.0, DHA-0.38-4.3, EPA+DHA-0.8-11 and AA-2-15. Values by fish oil (n-3 PUFA) vs. placebo groups are shown in the Figure. Higher levels of DHA and EPA (up to a threshold EPA ~ 3.5%) and lower levels of AA were associated with decreased rates of CV events (Table). For example, every 1% increase in EPA was associated with a 29% lower rate of CV events.

Fatty Acid	Rate Ratio per 1% increase (95% CI)	P-value
AA (univariate)	1.14 (1.03, 1.26)	0.014
With adjustment for AA
EPA	0.69 (0.53, 0.87)	0.002
DHA	0.67 (0.48, 0.92)	0.012
EPA + DHA	0.87 (0.88, 0.99)	0.032

Conclusion

Lower levels of EPA and DHA and higher levels of AA were associated with higher rates of serious cardiovascular events in persons treated with HD and may represent novel yet modifiable CV risk factors in this population.

Kewords