title: Role of far infra-red therapy in dialysis arterio-venous fistula maturation and survival: systematic review and meta-analysis.
abstract: BACKGROUND
  A well-functioning arteriovenous fistula (AVF) is the best modality for vascular access in patients with end-stage renal disease (ESRD) requiring haemodialysis (HD). However, AVFs' main disadvantage is the high rate of maturation failure, with approximately one third (20%-50%) not maturing into useful access. This review examine the use of Far-Infra Red therapy in an attempt to enhance both primary (unassisted) and secondary (assisted) patency rates for AVF in dialysis and pre-dialysis patients.
  
  
  METHODS
  We performed an online search for observational studies and randomised controlled trials (RCTs) that evaluated FIR in patients with AVF. Eligible studies compared FIR with control treatment and reported at least one outcome measure relating to access survival. Primary patency and secondary patency rates were the main outcomes of interest.
  
  
  RESULTS
  Four RCTs (666 patients) were included. Unassisted patency assessed in 610 patients, and was significantly better among those who received FIR (228/311) compared to (185/299) controls (pooled risk ratio of 1.23 [1.12-1.35], p = 0.00001). In addition, the two studies which reported secondary patency rates showed significant difference in favour of FIR therapy--160/168 patients--compared to 140/163 controls (pooled risk ratio of 1.11 [1.04-1.19], p = 0.003).
  
  
  CONCLUSIONS
  FIR therapy may positively influence the complex process of AVF maturation improving both primary and secondary patency rates. However blinded RCTs performed by investigators with no commercial ties to FIR therapy technologies are needed.
authors.affiliation: Department of vascular surgery, University Hospital Limerick, Limerick, Ireland.
authors.forename: Khalid
authors.initials: K
authors.lastname: Bashar
authors.affiliation: Department of vascular surgery, University Hospital Limerick, Limerick, Ireland.
authors.forename: Donagh
authors.initials: D
authors.lastname: Healy
authors.affiliation: Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical, Aeronautical & Biomedical Engineering, Materials and Surface Science Institute, University of Limerick, Limerick, Ireland.
authors.forename: Leonard D
authors.initials: LD
authors.lastname: Browne
authors.affiliation: Department of vascular surgery, University Hospital Limerick, Limerick, Ireland.
authors.forename: Elrasheid A H
authors.initials: EA
authors.lastname: Kheirelseid
authors.affiliation: Centre for Applied Biomedical Engineering Research (CABER), Department of Mechanical, Aeronautical & Biomedical Engineering, Materials and Surface Science Institute, University of Limerick, Limerick, Ireland.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Walsh
authors.affiliation: Department of vascular surgery, University Hospital Limerick, Limerick, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Clarke-Moloney
authors.affiliation: Department of vascular surgery, University Hospital Limerick, Limerick, Ireland.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Burke
authors.affiliation: Department of vascular surgery, University Hospital Limerick, Limerick, Ireland.
authors.forename: Eamon G
authors.initials: EG
authors.lastname: Kavanagh
authors.affiliation: Department of surgery, National University of Ireland, Galway, Ireland.
authors.forename: Stewart Redmond
authors.initials: SR
authors.lastname: Walsh
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007259:Infrared Rays / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000628:therapy; D064887:Observational Studies as Topic; D016032:Randomized Controlled Trials as Topic; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*