title: Clinical utility of far-infrared therapy for improvement of vascular access blood flow and pain control in hemodialysis patients.
abstract: BACKGROUND
  Maintenance of a well-functioning vascular access and minimal needling pain are important goals for achieving adequate dialysis and improving the quality of life in hemodialysis (HD) patients. Far-infrared (FIR) therapy may improve endothelial function and increase access blood flow (Qa) and patency in HD patients. The aim of this study was to evaluate effects of FIR therapy on Qa and patency, and needling pain in HD patients.
  
  
  METHODS
  This prospective clinical trial enrolled 25 outpatients who maintained HD with arteriovenous fistula. The other 25 patients were matched as control with age, sex, and diabetes. FIR therapy was administered for 40 minutes during HD 3 times/wk and continued for 12 months. The Qa was measured by the ultrasound dilution method, whereas pain was measured by a numeric rating scale at baseline, then once per month.
  
  
  RESULTS
  One patient was transferred to another facility, and 7 patients stopped FIR therapy because of an increased body temperature and discomfort. FIR therapy improved the needling pain score from 4 to 2 after 1 year. FIR therapy increased the Qa by 3 months and maintained this change until 1 year, whereas control patients showed the decrease in Qa. The 1-year unassisted patency with FIR therapy was not significantly different from control.
  
  
  CONCLUSIONS
  FIR therapy improved needling pain. Although FIR therapy improved Qa, the unassisted patency was not different compared with the control. A larger and multicenter study is needed to evaluate the effect of FIR therapy.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Soo Jeong
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: Artificial Kidney Unit, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Cho
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Hye Min
authors.initials: HM
authors.lastname: Jo
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Changwook
authors.initials: C
authors.lastname: Min
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Young Sok
authors.initials: YS
authors.lastname: Ji
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Moo Yong
authors.initials: MY
authors.lastname: Park
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Jin Kuk
authors.initials: JK
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Seung Duk
authors.initials: SD
authors.lastname: Hwang
keywords: Arteriovenous fistula; Far-infrared therapy; Hemodialysis; Pain