Society of Diabetic Nephropathy Prevention Journal of Nephropathology 2251-8363 15 4 2026 10 01 Omega-3 polyunsaturated fatty acid supplementation in chronic kidney disease; effects on inflammation, proteinuria, and renal function – a narrative review study e28734 e28734 10.34172/jnp.28734 EN Mahdi Amirdosara https://orcid.org/0000-0001-6865-4543 Zahra Sahraei https://orcid.org/0000-0002-0178-8624 Farzaneh Futuhi https://orcid.org/0000-0001-7137-2408 Journal Article 10.34172/jnp.28734 2026 04 15 2026 06 18 Chronic kidney disease (CKD) is a progressive disorder associated with high morbidity and mortality, primarily driven by cardiovascular complications and progression to end-stage renal disease (ESRD). Proteinuria and persistent low-grade inflammation are key mechanisms underlying disease progression. Omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been investigated as adjunctive therapeutic agents due to their anti-inflammatory, antioxidant, and antifibrotic properties. This narrative review synthesizes evidence from the literature to evaluate the effectiveness of omega-3 PUFA supplementation on proteinuria, inflammatory markers, and renal function in patients with CKD. A structured literature search was conducted using relevant Medical Subject Headings (MeSH) and free-text terms, including observational studies, randomized controlled trials (RCTs), systematic reviews, and meta-analyses published in English. The findings indicated that omega-3 PUFA supplementation is associated with a modest but statistically significant reduction in proteinuria, particularly in patients with IgA nephropathy, along with a decreased risk of ESRD. However, its effects on estimated glomerular filtration rate (eGFR) and serum creatinine clearance are generally not significant. The anti-inflammatory effects remain inconclusive, as most pooled analyses do not show significant reductions in markers such as C-reactive protein (CRP), interleukin-6 (IL-6), or tumor necrosis factor-alpha (TNF-α), although some benefit has been observed in hemodialysis patients with elevated baseline inflammation. Experimental studies more consistently demonstrate antioxidant and antifibrotic effects. Overall, omega-3 PUFAs may serve as a supportive therapy in CKD management, particularly for reducing proteinuria and delaying disease progression, although further large-scale, well-designed clinical trials are necessary to confirm definitive clinical recommendations.