title: Effect of far infrared therapy on arteriovenous fistula maturation: an open-label randomized controlled trial.
abstract: BACKGROUND
  Malfunction of the arteriovenous fistula (AVF) is an important cause of morbidity and hospitalization in hemodialysis (HD) patients. The aim of this study is to evaluate the effect of far infrared therapy on the maturation and patency of newly created AVFs in patients with chronic kidney disease stage 4 or 5.
  
  
  METHODS
  Randomized controlled study.
  
  
  METHODS
  Patients with estimated glomerular filtration rate of 5-20 mL/min/1.73 m².
  
  
  METHODS
  40 minutes of far infrared therapy 3 times weekly for a year.
  
  
  RESULTS
  The primary outcome is the rate of AVF malfunction within 12 months, with malfunction defined as either: (1) thrombosis without thrill for AVFs not undergoing HD or (2) receiving any type of interventional procedure due to a lower Kt/V (<1.2) for patients undergoing HD. Secondary outcomes include: (1) cumulative primary unassisted AVF patency, defined as time from creation of the AVF to the first episode of AVF malfunction; (2) physiologic maturation of the AVF by the definition of AVF access blood flow (Qa) ≥500 mL/min and AVF diameter ≥4 mm at 3 months; and (3) clinical maturation of the AVF suitable for HD at 1 year.
  
  
  METHODS
  AVF Qa was measured by Doppler ultrasonography at 2 days and 1, 2, 3, and 12 months.
  
  
  RESULTS
  We enrolled 122 patients who were randomly allocated to the intervention (n = 60) and control (n = 62) groups. In comparison to controls, patients in the intervention group had higher Qa values at 1, 2, 3, and 12 months; a higher rate of physiologic maturation (90% vs 76%; P = 0.04) at 3 months; and a lower rate of AVF malfunction (12% vs 29%; P = 0.02) but higher rates of AVF cumulative unassisted patency (87% vs 70%; P = 0.01) and clinical maturation (82% vs 60%; P = 0.008) within 12 months.
  
  
  CONCLUSIONS
  This is a single-center nonblinded study.
  
  
  CONCLUSIONS
  Far infrared therapy improves the access flow, maturation, and patency of newly created AVFs in patients with chronic kidney disease stages 4 and 5.
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan. lincc2@vghtpe.gov.tw
authors.forename: Chih-Ching
authors.initials: CC
authors.lastname: Lin
authors.forename: Wu-Chang
authors.initials: WC
authors.lastname: Yang
authors.forename: Min-Chi
authors.initials: MC
authors.lastname: Chen
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Liu
authors.forename: Chih-Yu
authors.initials: CY
authors.lastname: Yang
authors.forename: Pui-Ching
authors.initials: PC
authors.lastname: Lee
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007259:Infrared Rays; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis
keywords: Arteriovenous fistula (AVF); chronic kidney disease (CKD); far infrared therapy; hemodialysis (HD); maturation