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Background   Omega-3 fatty acids ( FAs)  have been suggested as a beneficial supplement in chronic kidney disease (CKD) patients, but the results of randomized clinical trials (RCTs) are controversial. We conducted a systematic review and meta-analysis to evaluate all the RCTs about the impact of  omega-3 FAs supplementation on cardiometabolic outcomes and oxidative stress parameters in patients with CKD.    Methods  We performed a systematic database search in  PubMed/MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Central, up to May 2020.  We included all placebo-controlled randomized trials that assessed the effect of  omega-3 FAs supplementation on  any  cardiometabolic outcomes : blood pressure, total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) or triglycerides (TG) and oxidative stress parameters. Data were pooled using DerSimonian–Laird’s random-effects model.    Results  Finally, thirteen articles met the inclusion criteria for this review omega-3 FAs supplementation significantly decrease TC (SMD: -0.26; 95% CI: − 0.51, − 0.02; I 2  = 52.7%), TG (SMD: -0.22; 95% CI: − 0.43, − 0.02; I 2  = 36.0%) and Malondialdehyde (MDA) levels (SMD: -0.91; 95% CI: − 1.29, − 0.54; I 2  = 00.0%) and also significantly increase superoxide dismutase (SOD) (SMD: 0.58; 95% CI: 0.27, 0.90; I 2  = 00.0%) and Glutathione peroxidase (GPx) (SMD: 0.50; 95% CI: 0.14, 0.86; I 2  = 00.0%) activities. However our results show that omega-3 FAs supplementation have no significant effects on HDL, LDL and blood pressure.  Conclusion  This systematic review and meta-analysis supports current evidence for the clinical benefit of omega-3 FAs intake to improve cardiometabolic parameters in CKD patients. However, well-designed RCTs still needed to provide a conclusive picture in this field.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12882-021-02351-9.

bmc nephrology

Effect of omega-3 fatty acids supplementation on cardio-metabolic and oxidative stress parameters in patients with chronic kidney disease: a systematic review and meta-analysis