Protection against Incidences of Serious Cardiovascular Events Study with daily fish oil supplementation in dialysis patients (PISCES): protocol for a randomised controlled trial

Introduction Patients with kidney failure with replacement therapy (KFRT) suffer premature cardiovascular (CV) mortality and events with few proven pharmacological interventions. Omega-3 polyunsaturated essential fatty acids (n-3 PUFAs) are associated with a reduced risk of CV events and death in no...

Full description

Saved in:
Bibliographic Details
Main Authors: Kevan Polkinghorne, Brenda R Hemmelgarn, Marcello Tonelli, George Tomlinson, Charmaine E Lok, Louise M Moist
Format: Article
Language:English
Published: BMJ Publishing Group 2024-01-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/1/e072239.full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850067939373350912
author Kevan Polkinghorne
Brenda R Hemmelgarn
Marcello Tonelli
George Tomlinson
Charmaine E Lok
Louise M Moist
author_facet Kevan Polkinghorne
Brenda R Hemmelgarn
Marcello Tonelli
George Tomlinson
Charmaine E Lok
Louise M Moist
author_sort Kevan Polkinghorne
collection DOAJ
description Introduction Patients with kidney failure with replacement therapy (KFRT) suffer premature cardiovascular (CV) mortality and events with few proven pharmacological interventions. Omega-3 polyunsaturated essential fatty acids (n-3 PUFAs) are associated with a reduced risk of CV events and death in non-dialysis patients and in patients with established CV disease but n-3 PUFAs have not been evaluated in the high risk KFRT patient population.Methods and analysis This multicentre randomised, placebo controlled, parallel pragmatic clinical trial tests the hypothesis that oral supplementation with n-3 PUFA, when added to usual care, leads to a reduction in the rate of serious CV events in haemodialysis patients when compared with usual care plus matching placebo. A target sample size of 1100 KFRT patients will be recruited from 26 dialysis units in Canada and Australia and randomised to n-3 PUFA or matched placebo in a 1:1 ratio with an expected intervention period of at least 3.5 years. The primary outcome to be analysed and compared between intervention groups is the rate of all, not just the first, serious CV events which include sudden and non-sudden cardiac death, fatal and non-fatal myocardial infarction, stroke, and peripheral vascular disease events.Ethics and dissemination This study has been approved by all institutional ethics review boards involved in the study. Participants could only be enrolled following informed written consent. Results will be published in peer-reviewed journals and presented at scientific and clinical conferences.Trial registration number ISRCTN00691795
format Article
id doaj-art-983ddaaa0c8b4d28b150b8e90137ad9e
institution DOAJ
issn 2044-6055
language English
publishDate 2024-01-01
publisher BMJ Publishing Group
record_format Article
series BMJ Open
spelling doaj-art-983ddaaa0c8b4d28b150b8e90137ad9e2025-08-20T02:48:10ZengBMJ Publishing GroupBMJ Open2044-60552024-01-0114110.1136/bmjopen-2023-072239Protection against Incidences of Serious Cardiovascular Events Study with daily fish oil supplementation in dialysis patients (PISCES): protocol for a randomised controlled trialKevan Polkinghorne0Brenda R Hemmelgarn1Marcello Tonelli2George Tomlinson3Charmaine E Lok4Louise M Moist5Department of Medicine, Monash University, Clayton, Melbourne, AustraliaDivision of Nephrology, University of Alberta, Edmonton, Alberta, CanadaDivision of Nephrology, University of Calgary, Calgary, Alberta, CanadaDepartment of Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, CanadaDepartment of Medicine, Division of Nephrology, University of Toronto, Toronto, Ontario, CanadaDivision of Nephrology, London Health Sciences Centre, London, Ontario, CanadaIntroduction Patients with kidney failure with replacement therapy (KFRT) suffer premature cardiovascular (CV) mortality and events with few proven pharmacological interventions. Omega-3 polyunsaturated essential fatty acids (n-3 PUFAs) are associated with a reduced risk of CV events and death in non-dialysis patients and in patients with established CV disease but n-3 PUFAs have not been evaluated in the high risk KFRT patient population.Methods and analysis This multicentre randomised, placebo controlled, parallel pragmatic clinical trial tests the hypothesis that oral supplementation with n-3 PUFA, when added to usual care, leads to a reduction in the rate of serious CV events in haemodialysis patients when compared with usual care plus matching placebo. A target sample size of 1100 KFRT patients will be recruited from 26 dialysis units in Canada and Australia and randomised to n-3 PUFA or matched placebo in a 1:1 ratio with an expected intervention period of at least 3.5 years. The primary outcome to be analysed and compared between intervention groups is the rate of all, not just the first, serious CV events which include sudden and non-sudden cardiac death, fatal and non-fatal myocardial infarction, stroke, and peripheral vascular disease events.Ethics and dissemination This study has been approved by all institutional ethics review boards involved in the study. Participants could only be enrolled following informed written consent. Results will be published in peer-reviewed journals and presented at scientific and clinical conferences.Trial registration number ISRCTN00691795https://bmjopen.bmj.com/content/14/1/e072239.full
spellingShingle Kevan Polkinghorne
Brenda R Hemmelgarn
Marcello Tonelli
George Tomlinson
Charmaine E Lok
Louise M Moist
Protection against Incidences of Serious Cardiovascular Events Study with daily fish oil supplementation in dialysis patients (PISCES): protocol for a randomised controlled trial
BMJ Open
title Protection against Incidences of Serious Cardiovascular Events Study with daily fish oil supplementation in dialysis patients (PISCES): protocol for a randomised controlled trial
title_full Protection against Incidences of Serious Cardiovascular Events Study with daily fish oil supplementation in dialysis patients (PISCES): protocol for a randomised controlled trial
title_fullStr Protection against Incidences of Serious Cardiovascular Events Study with daily fish oil supplementation in dialysis patients (PISCES): protocol for a randomised controlled trial
title_full_unstemmed Protection against Incidences of Serious Cardiovascular Events Study with daily fish oil supplementation in dialysis patients (PISCES): protocol for a randomised controlled trial
title_short Protection against Incidences of Serious Cardiovascular Events Study with daily fish oil supplementation in dialysis patients (PISCES): protocol for a randomised controlled trial
title_sort protection against incidences of serious cardiovascular events study with daily fish oil supplementation in dialysis patients pisces protocol for a randomised controlled trial
url https://bmjopen.bmj.com/content/14/1/e072239.full
work_keys_str_mv AT kevanpolkinghorne protectionagainstincidencesofseriouscardiovasculareventsstudywithdailyfishoilsupplementationindialysispatientspiscesprotocolforarandomisedcontrolledtrial
AT brendarhemmelgarn protectionagainstincidencesofseriouscardiovasculareventsstudywithdailyfishoilsupplementationindialysispatientspiscesprotocolforarandomisedcontrolledtrial
AT marcellotonelli protectionagainstincidencesofseriouscardiovasculareventsstudywithdailyfishoilsupplementationindialysispatientspiscesprotocolforarandomisedcontrolledtrial
AT georgetomlinson protectionagainstincidencesofseriouscardiovasculareventsstudywithdailyfishoilsupplementationindialysispatientspiscesprotocolforarandomisedcontrolledtrial
AT charmaineelok protectionagainstincidencesofseriouscardiovasculareventsstudywithdailyfishoilsupplementationindialysispatientspiscesprotocolforarandomisedcontrolledtrial
AT louisemmoist protectionagainstincidencesofseriouscardiovasculareventsstudywithdailyfishoilsupplementationindialysispatientspiscesprotocolforarandomisedcontrolledtrial