Consumption of Fish in Chronic Kidney Disease – A Matter of Depth

Abstract Fish is an excellent source of ω‐3 polyunsaturated fatty acids (PUFAs), amino acids, collagen, vitamins, and iodine and its intake is associated with health benefits, mainly reduces risk of cardiovascular mortality. However, recent studies have shown that fish is also an important source of trimethylamine N ‐oxide (TMAO), a uremic toxin produced by the gut microbiota that promotes an increased risk of cardiovascular diseases. In patients with chronic kidney disease (CKD), TMAO levels are markedly increased due to gut dysbiosis and reduced kidney function. No study has yet evaluated the effects of a fish‐rich diet on TMAO plasma levels and cardiovascular outcomes. This review discusses the pros and cons of a fish‐rich diet in patients with CKD – a matter of depth.