What is it?

Fish oil contains omega-3 fatty acids. There are two different types of omega-3 fatty acids: EPA and DHA.

Fish oil is NOT the same as cod liver oil or halibut liver oil. These fish liver oils contain large amounts of vitamin A. Large amounts of vitamin A are not recommended for people with kidney disease.

Why did my doctor prescribe or recommend it?

You have a kidney disease called IgA Nephropathy. Most people with this condition maintain normal kidney function. However, in some patients (about 30%) kidney function may get worse over time. Your doctor (nephrologist) thinks you may be one of those people whose kidneys may worsen over the years. Fish oil therapy may prevent or slow down the worsening.

Is it Effective?

Fish oil is used to slow the progression of kidney disease in people with IgA nephropathy.  While fish oil capsules may be effective in many patients, some patients do not respond to it.

How does it work?

The omega-3 fatty acids in fish oil prevent inflammation in the kidney to slow down progression of kidney disease.

How will you know if it is working?

Your blood tests may show a decrease in the creatinine level (creatinine measures kidney function). Please note that fish oil does not usually decrease the amount of protein in the urine. Certain blood pressure pills and prednisone pills are used to decrease protein in the urine.

An additional benefit is that fish oil may lower the level of fats called triglycerides in your blood.

Are there safety concerns?

Fish oil is generally safe and most people do not experience any side effects. Others may notice belching, fishy-smelling breath, heartburn or diarrhea. Taking your fish oil capsules with meals can decrease these side effects.

Are there any interactions with medications?

Medications that slow blood clotting (e.g. aspirin, clopidogrel (Plavix) and warfarin (Coumadin))

Fish oils may slow blood clotting. Taking fish oils along with medications that also slow clotting may increase the chances of bruising and bleeding.

Medications for high blood pressure:

Fish oils may decrease blood pressure. Taking fish oils along with medications for high blood pressure may cause your blood pressure to go too low. Fish oil also might improve your blood pressure if it is too high. Good blood pressure control is an important part of treating IgA nephropathy. Target blood pressure for people with kidney disease is 130/80 mm Hg or lower.

What doses are recommended?

We recommend that you take a total of 1000-1200 mg DHA and 1800-2000 mg EPA. This means taking five to 10 capsules of fish oil each day. 

How should you take it?

It is best to divide your capsules two or three times per day with meals (e.g. if 10 capsules required each day, take four with breakfast, three with lunch and three with supper).

What products are recommended?

The product you are using should specify on the label exactly how much DHA and EPA are present in each capsule. If you are using a product other than one listed in the table, please bring it with you to your next Renal Health Clinic appointment so we can verify that it is appropriate.

Fish oil products available:

Product Name	Store*	DHA/EPA Content (mg)/capsule	Required dose	Cost**	Cost/month**
Webber Naturals Omega-3 Mini Softgels (easy swallow)	Costco	120/180	10 capsules	$19.99/360	$15.00
Exact Super Concentrate Omega-3 1170 mg	Superstore	200/400	5 capsules	$29.99/240	$18.70
Webber Naturals Double Strength Omega-3 600 mg	Superstore	200/400	5 capsules	$19.97/80	$37.50
Webber Naturals Wilkd Alaskan Salmon & Fish Oil	Superstore	120/180	10 capsules	$19.97/220	$27.00
NutraSea Omega-3 Liquid (in different flavors- lemon, mango)	Superstore	500/750 per teaspoon (5 mL)	2 teaspoons (10 mL)	$23.99/200 mL	$36.00
Equate Omega-3 1000 mg	Walmart	200/300	6 capsules	$10.97/200	$9.00
Equate Omega-3 1000 mg	Walmart	120/180	10 capsules	$10.97/300	$12.00
Equate Wild Alaskan Salmon & Fish Oil 1000 mg	Walmart	120/180	10 capsules	$12.97/300	$12.00
Jamieson Salmon Oil Omega 3 Complex	Walmart	120/80	10 capsules	$11.97/200	$15.00
Health First Omega First Riple Fish Oil (liquid)	Vita Health	550/850 per teaspoon (5 mL)	2 teaspoons (10 mL)	$23.00/250 mL	$26.39
Natural Factors Rx Omega-3 600 mg	Vita Health	200/400	5 capsules	$26.99/150	$27.00

* Product may also be available at other stores.

**Prices as of March 2017

Prepared by:  L. Wazny, May 2005. (N. Lee, Revised March 2017, )