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Far-Infrared Therapy: A Novel Treatment to Improve Access Blood Flow and Unassisted Patency of Arteriovenous Fistula in Hemodialysis Patients

Chih-Ching Lin^*,,, Chao-Fu Chang^,,, Ming-Yu Lai^*,, Tzen-Wen Chen^*,, Pui-Ching Lee^|| and Wu-Chang Yang^*,

^* Division of Nephrology and ^|| Department of Medicine, Taipei Veterans General Hospital, Institute of Clinical Medicine and School of Medicine, National Yang-Ming University, and Municipal Hoping Hospital, Taipei, Taiwan, Republic of China

Address correspondence to: Dr. Wu-Chang Yang, Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan 112, Republic of China. Phone: +886-2-2875-7517; Fax: +886-2-2873-4866; E-mail: wcyang{at}vghtpe.gov.tw l1124{at}ms12.hinet.net

Received for publication May 27, 2006. Accepted for publication December 11, 2006.

Vascular access malfunction, usually presenting with an inadequate access flow (Qa), is the leading cause of morbidity and hospitalization in hemodialysis (HD) patients. Many methods of thermal therapy have been tried for improving Qa but with limited effects. This randomized trial was designed to evaluate the effect of far-infrared (FIR) therapy on access flow and patency of the native arteriovenous fistula (AVF). A total of 145 HD patients were enrolled with 73 in the control group and 72 in the FIR group. A WS TY101 FIR emitter was used for 40 min, and hemodynamic parameters were measured by the Transonic HD₀₂ monitor during HD. The Qa₁/Qa₂ and Qa₃/Qa₄ were defined as the Qa measured at the beginning/at 40 min later in the HD session before the initiation and at the end of the study, respectively. The incremental change of Qa in the single HD session with FIR therapy was significantly higher than that without FIR therapy (13.2 ± 114.7 versus –33.4 ± 132.3 ml/min; P = 0.021). In comparison with control subjects, patients who received FIR therapy for 1 yr had (1) a lower incidence (12.5 versus 30.1%; P < 0.01) and relative incidence (one episode per 67.7 versus one episode per 26.7 patient-months; P = 0.03) of AVF malfunction; (2) higher values of the following parameters, including (Qa₄ – Qa₃) (36.2 ± 82.4 versus –12.7 ± 153.6 ml/min; P = 0.027), (Qa₃ – Qa₁) (36.3 ± 166.2 versus –51.7 ± 283.1 ml/min; P = 0.035), (Qa₄ – Qa₂) (99.2 ± 144.4 versus –47.5 ± 244.5 ml/min; P < 0.001), and (Qa₄ – Qa₂) – (Qa₃ – Qa₁) (62.9 ± 111.6 versus 4.1 ± 184.5 ml/min; P = 0.032); and (3) a better unassisted patency of AVF (85.9 versus 67.6%; P < 0.01). In conclusion, FIR therapy, a noninvasive and convenient therapeutic modality, can improve Qa and survival of the AVF in HD patients through both its thermal and its nonthermal effects.

This article has been cited by other articles:

				C.-C. Lin, X.-M. Liu, K. Peyton, H. Wang, W.-C. Yang, S.-J. Lin, and W. Durante Far Infrared Therapy Inhibits Vascular Endothelial Inflammation via the Induction of Heme Oxygenase-1 Arterioscler. Thromb. Vasc. Biol., April 1, 2008; 28(4): 739 - 745. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673