Background: Aboriginal people requiring haemodialysis experience high cardiovascular mortality. Dietary interventions have uncertain effects on mortality and cardiovascular events in people with end-stage kidney disease (ESKD).

Aim: To determine if a dietary intervention of fish and fruit would decrease all-cause and cardiovascular mortality in Aboriginal people requiring haemodialysis.

Methods: A randomised dietary intervention of 300gm fish and five portions of fruit spaced over three dialysis treatments per week versus usual renal diet. Blood concentrations of omega-3 and omega-6 polyunsaturated fatty acids (n-3 PUFA and n-6 PUFA respectively) were recorded over a 12-month period.

Results: The mean age of the 151 randomised patients was 53 years; 42% were males, 94% of Aboriginal people and 74% with diabetes. There was no significant difference in n-3 PUFA concentration over the follow-up. The cardiovascular mortality rate was not different between the intervention and control group assessed at 2.1 years follow-up (3.7 v 4.3%, p=0.92), or at 5.0 years follow-up (19.7% v 21.8%, p=0.93).

Conclusions: The 12-month diet intervention including fish and fruit meal supplementation did not provide a survival advantage in patients with very low baseline n-3:n-6 PUFA ratio.