Fish oils for dialysis patients

ROCHESTER, MINNESOTA. Hemodialysis in patients with kidney failure requires that the blood to be cleaned is drawn from the body, pumped through the dialysis machine, and then returned to the body. Because relatively large amounts of blood are handled, it is necessary to use large catheters to draw and return the blood. In order to avoid the discomfort, pain and inconvenience of repeated puncture of the veins most patients on long-term maintenance dialysis now have a permanent access system (graft) made from Gore-Tex(polytetrafluoroethylene) implanted in the arm. While this is convenient, the implant is also a potent breeding ground for blood clots and tends to become obstructed over time. It is estimated that the annual cost of maintaining dialysis access exceeds 1 billion dollars and that more than 50% of all access grafts experience thrombosis within one year after placement.

Researchers at the St. Louis University School of Medicine now report that fish oil supplementation is highly effective in helping to avoid thrombosis and maintaining unobstructed access in grafts. Their clinical trial involved 24 patients with newly implanted polytetrafluoroethylene access grafts. Half the patients were randomized to receive 4 grams/day of fish oil (1.8 g EPA + 1.0 g DHA) while the other half received 4 grams/day of corn oil. At the end of the 12-month follow-up period the researchers found that access was still unobstructed in 76% of the patients given fish oil as compared to only 15% of those given corn oil. They conclude that fish oils possess unique biologic properties that make them effective in the prevention of graft access thrombosis.
Schmitz, PG, et al. Prophylaxis of hemodialysis graft thrombosis with fish oil: double-blind, randomized, prospective trial. Journal of the American Society of Nephrology, Vol. 13, 2002, pp. 184-90

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