title: Traditional Thermal Therapy with Indirect Moxibustion Decreases Renal Arterial Resistive Index in Patients with Chronic Kidney Disease.
abstract: OBJECTIVE
  To evaluate the immediate effects of traditional local thermal therapy with indirect moxibustion on renal hemodynamics in patients with chronic kidney disease (CKD) by using Doppler ultrasonography (US).
  
  
  METHODS
  Examiner-blinded crossover study.
  
  
  METHODS
  Forty-three participants with CKD (mean age ± standard deviation [SD], 44 ± 15 years; estimated glomerular filtration rate, 69.5 ± 25.5 mL/min per 1.73 m(2); 20 men and 23 women).
  
  
  METHODS
  Participants received three successive treatment sessions of indirect moxibustion bilaterally at BL 23, a crucial acupuncture point, in the session. In the control session, the examiner was blinded by using smoke and aroma produced by moxibustion performed in an ashtray placed near the patient's body.
  
  
  METHODS
  The main outcome measure was resistive index (RI) in the renal segmental arteries. Blood flow parameters, including RI, were measured for six renal segmental arteries by using Doppler US at rest (baseline), immediately after completion of moxibustion (post 1), and 10 minutes later (post 2). Adverse events were monitored during intervention.
  
  
  RESULTS
  In the control session, RI at post 1 (median [first, third quartile]: 0.587 [0.562, 0.626]) and post 2 (0.583 [0.567, 0.629]) did not change significantly compared with baseline (0.592 [0.563, 0.636]), while in the treatment session, RI at post 1 (0.565 [0.530, 0.618]) and post 2 (0.561 [0.533, 0.614]) decreased significantly compared with baseline (0.590 [0.550, 0.652]) (p < 0.001 and p < 0.001, respectively). The reduction in RI from baseline to post 2 in treatment session was significantly greater than in control session (mean ± SD, -0.026 ± 0.028 versus -0.003 ± 0.028; mean difference, -0.023 [95% confidence interval, -0.036 to -0.010]; p = 0.001]. No adverse events, such as burns, were observed during the study period.
  
  
  CONCLUSIONS
  Renal vascular resistance was decreased after indirect moxibustion therapy in patients with CKD.
authors.affiliation: 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan .
authors.forename: Jun
authors.initials: J
authors.lastname: Matsumoto-Miyazaki
authors.affiliation: 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan .
authors.forename: Nagisa
authors.initials: N
authors.lastname: Miyazaki
authors.affiliation: 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan .|2 Department of Chronic Kidney Disease, Gifu University Graduate School of Medicine , Gifu, Japan .
authors.forename: Ichijiro
authors.initials: I
authors.lastname: Murata
authors.affiliation: 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan .
authors.forename: Gakuro
authors.initials: G
authors.lastname: Yoshida
authors.affiliation: 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan .|3 Advanced Critical Care Center, Gifu University Hospital , Gifu, Japan .
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ushikoshi
authors.affiliation: 3 Advanced Critical Care Center, Gifu University Hospital , Gifu, Japan .|4 Department of Emergency and Disaster Medicine, Gifu University Graduate School of Medicine , Gifu, Japan .
authors.forename: Shinji
authors.initials: S
authors.lastname: Ogura
authors.affiliation: 1 Department of Cardiology and Respirology, Gifu University Graduate School of Medicine , Gifu, Japan .
authors.forename: Shinya
authors.initials: S
authors.lastname: Minatoguchi
mesh_terms: D000328:Adult; D001794:Blood Pressure; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000000981:diagnostic imaging / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009071:Moxibustion; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000628:therapy*; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance / Q000502:physiology*