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Clinical Dialysis
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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
JASN March 2007, 18 (3) 985-992; DOI: https://doi.org/10.1681/ASN.2006050534
Chih-Ching Lin
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Chao-Fu Chang
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Ming-Yu Lai
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Tzen-Wen Chen
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Pui-Ching Lee
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Wu-Chang Yang
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    Figure 1.

    Flow chart of the study participants for the randomized, controlled trial to evaluate the effect of far-infrared (FIR) therapy on survival of arteriovenous fistula (AVF) in the hemodialysis (HD) patients.

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    Figure 2.

    Comparison of 1-yr survival curves for unassisted patency of AVF between the HD patients with or without FIR therapy. P < 0.01 for the comparison between the two survival curves by log rank test.

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    Table 1.

    Clinical characteristics of the two groups of HD patients with and without FIR treatment during the study perioda

    CharacteristicControl GroupFIR GroupP
    n7372
    Age (yr)59.2 ± 15.061.9 ± 14.40.87
    Gender (male)38 (52.1)37 (51.4)0.94
    HD duration (mo)79.2 ± 42.285.2 ± 41.10.76
    Prevalence of hypertension39 (53.4)40 (55.6)0.80
    Prevalence of diabetes24 (32.9)25 (34.7)0.81
    History of AVF malfunctionb34 (46.6)33 (45.8)0.81
    No. of angioplasty (patients/procedures)20/4620/490.87
    No. of surgical revision (patients/procedures)14/1913/200.56
    Duration of AVF (mo)58.7 ± 33.856.8 ± 36.40.91
    Creation of another AVF (n)c4 (5.5)1 (1.4)0.18
    Renal transplantation (n)1 (1.4)2 (2.8)0.55
    Peritoneal dialysis (n)2 (2.7)2 (2.8)0.99
    Death with functioning AVF (n)2 (2.7)3 (4.2)0.64
    Loss to follow-up (n)01 (1.4)0.31
    • ↵a Data are n (%) unless otherwise indicated. AVF, arteriovenous fistula; FIR, far-infrared; HD, hemodialysis.

    • ↵b Defined as the need for any interventional procedure (surgery or angioplasty) to correct a malfunctioning or occlusive fistula not resulting from the following stenosis-unrelated events, such as infectious complication, progressive aneurysmal formation, or steal syndrome.

    • ↵b Creation of another AVF during this 1-yr study.

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    Table 2.

    Access flow and the hemodynamic parameters of the 72 HD patients in the single HD session with or without FIR therapya

    ParameterHD Session without FIRHD Session with FIRP
    SBP1 (mmHg)134.2 ± 23.9130.7 ± 19.00.86
    SBP2 (mmHg)132.1 ± 19.1129.4 ± 17.30.74
    Δ(SBP2 − SBP1) (mmHg)−2.1 ± 14.5−1.3 ± 14.80.68
    Qa1 (ml/min)976.6 ± 491.2967.8 ± 421.00.94
    Qa2 (ml/min)943.2 ± 472.2981.0 ± 430.80.36
    Δ(Qa2 − Qa1) (ml/min)−33.4 ± 132.313.2 ± 114.70.021
    CO1 (L/min)4.75 ± 1.384.72 ± 1.100.91
    CO2 (L/min)4.45 ± 1.254.34 ± 1.160.88
    Δ(CO2 − CO1) (L/min)−0.30 ± 0.75−0.38 ± 0.740.77
    Qa1/CO10.223 ± 0.0900.217 ± 0.0760.78
    Qa2/CO20.216 ± 0.0820.235 ± 0.0990.42
    Δ[(Qa2/CO2) − (Qa1/CO1)]−0.007 ± 0.0570.018 ± 0.0560.027
    TPR1 (mmHg × min/L)21.29 ± 5.5620.86 ± 4.810.89
    TPR2 (mmHg × min/L)22.86 ± 6.0922.67 ± 5.570.92
    Δ(TPR2 − TPR1) (mmHg × min/L)1.56 ± 4.351.82 ± 3.980.81
    • ↵a CO, cardiac output; Qa, access flow; SBP, systolic BP; TPR, total peripheral resistance; 1, timing of measuring the parameter is within the first hour after initiation of HD session or immediately before FIR treatment; 2, timing of measuring the parameter is 40 min after timing 1 or immediately after FIR treatment. Boldface P values indicate P < 0.05.

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    Table 3.

    Comparison of the access flow and survival of AVF between HD patients with and without FIR therapy for 1 yra

    ParameterControl GroupFIR GroupP
    No. completing study6463—
    Qa1 (ml/min)992.8 ± 473.8975.2 ± 421.90.58
    Qa2 (ml/min)975.9 ± 444.3948.6 ± 432.70.26
    Δ(Qa2 − Qa1) (ml/min)−16.9 ± 130.3−26.6 ± 105.50.72
    Qa1/CO10.206 ± 0.0880.204 ± 0.0780.90
    Qa2/CO20.223 ± 0.0950.225 ± 0.1070.93
    Δ[(Qa2/CO2) − (Qa1/CO1)]0.017 ± 0.0600.021 ± 0.0590.75
    Qa3 (ml/min)941.1 ± 367.91011.6 ± 447.00.14
    Qa4 (ml/min)928.4 ± 387.51047.8 ± 463.20.07
    Qa3/CO30.194 ± 0.0710.213 ± 0.0770.16
    Qa4/CO40.197 ± 0.0740.237 ± 0.0790.004
    Δ(Qa4 − Qa3) (ml/min)−12.7 ± 153.636.2 ± 82.40.027
    Δ[(Qa4/CO4) − (Qa3/CO3)]0.003 ± 0.0470.024 ± 0.0330.004
    Δ(Qa3 − Qa1) (ml/min)−51.7 ± 283.136.3 ± 166.20.035
    Δ[(Qa3/CO3) − (Qa1/CO1)]−0.012 ± 0.0640.009 ± 0.0400.031
    Δ(Qa4 − Qa2) (ml/min)−47.5 ± 244.599.2 ± 144.4<0.001
    Δ[(Qa4/CO4) − (Qa2/CO2)]−0.026 ± 0.0560.013 ± 0.060<0.001
    Δ(Qa4 − Qa2) − Δ(Qa3 − Qa1) (ml/min)4.1 ± 184.562.9 ± 111.60.032
    Δ[(Qa4/CO4) − (Qa2/CO2)] − Δ[(Qa3/CO3) − (Qa1/CO1)]−0.014 ± 0.0680.004 ± 0.0680.049
    No. starting study7372—
        patients with new AVF malfunction (%)22 (30.1%)9 (12.5%)<0.01
        patients with thrombosis of AVF6 (8.2%)2 (2.8%)0.15
    Patients with intervention of AVF16 (21.9%)7 (9.7%)0.044
    Total observations (patient-months)802.4812.6—
    New episodes of AVF malfunction during study3012—
    Episode of AVF malfunction/patient-months1/26.71/67.70.03
    • ↵a Qa1, access flow measured within first hour after the initiation of the HD session immediately before the commencement of this study; Qa2, access flow measured 40 min after Qa1 measurement during the HD session immediately before the commencement of this study; Qa3, access flow measured before FIR treatment or within first hour after the initiation of the HD session when the study was completed; Qa4, access flow measured 40 min after Qa3 or immediately after FIR treatment during the HD session when the study was completed; Δ(Qa4 − Qa3), sum of the thermal effect by FIR and the hemodynamic effect by HD on the change of Qa; Δ(Qa3 − Qa1), nonthermal effect of 1 yr of FIR on the change of Qa; Δ(Qa4 − Qa2), sum of the thermal effect (for 40 min) and the nonthermal effect (for 1 yr) by FIR on Qa; [Δ(Qa4 − Qa2) − Δ(Qa3 − Qa1)], thermal effect of 40 min of FIR on the change of Qa.

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Journal of the American Society of Nephrology: 18 (3)
Journal of the American Society of Nephrology
Vol. 18, Issue 3
March 2007
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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, Wu-Chang Yang
JASN Mar 2007, 18 (3) 985-992; DOI: 10.1681/ASN.2006050534

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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, Wu-Chang Yang
JASN Mar 2007, 18 (3) 985-992; DOI: 10.1681/ASN.2006050534
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More in this TOC Section

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