Far-infrared therapy for secondary vascular access patency of hemodialysis patients

Abstract

Introduction: Far-infrared radiation therapy (FIRT), which utilizes an invisible electromagnetic wave, has demonstrated its ability to improve vascular access flow for hemodialysis (HD) patients. Although previous overseas studies revealed the beneficial effects of FIRT on HD patients by improving vascular function, no study in Japan has examined the clinical efficacy of FIRT for such patients. Therefore, we aimed to evaluate the usefulness of FIRT for HD patients. We paid particular attention on secondary vascular access (VA) patency of HD patients. Methods: Eighteen patients who had undergone vasodilation of VA vessels or vascularization more than once were selected from approximately 70 outpatients receiving HD in the Dialysis Unit of the Juntendo University Hospital. FIRT was administered for 40 min during HD three times per week for 1 year to the not frequent VA treatment (nf-VAT) group, for which VA intervention had been performed no more than two times during the 1 year, and to the frequent VA treatment (f-VAT) group, for which VA intervention had been performed three times or more over the 1 year. Variables including VA treatment interval were compared between those groups. Results: The nf-VAT group did not require VA re-treatment during the study period. The VA treatment interval was significantly prolonged in the f-VAT group. The fistula diameter expanded, and intimal thickening improved significantly in the nf-VAT group. Oxidized low-density lipoprotein cholesterol levels decreased slightly. Conclusion: This study suggested that FIRT is effective for improving secondary VA patency. Trial registration: UMIN, UMIN000011965.

Effects of Far-Infrared Therapy on Foot Circulation Among Hemodialysis Patients With Diabetes Mellitus

“…We administered the FIR therapy in the present study from a distance of 25 cm above the skin surface for 40 min per session. The skin temperature steadily increased by 1-2 C in tissues with a depth of 10 mm until it reached a plateau of 37.5-38.2 C, which is similar to that reported by Lo et al (2019). This increase in skin temperature causes vasodilation, promotes blood flow, and improves circulation.…”

“…Evidence further suggests that FIR inhibits vessel endothelium growth, reduces vessel sclerosis associated with oxidative stress, and improves vessel repair effects (Chang, 2018;Choi et al, 2016;Lin et al, 2016). Such therapy may thus improve vessel dilation and/or circulation, vessel endothelial function, and angiogenesis (Chen, Lee, et al, 2016;Chen, Yang, et al, 2016;Lo et al, 2019;Yu et al, 2006). Indeed, research has shown that FIR therapy reduces atherosclerosis in humans (Chen, Lee, et al, 2016;Chen, Yang, et al, 2016;Choi et al, 2016;Lo et al, 2019;Yu et al, 2006).…”

“…Such therapy may thus improve vessel dilation and/or circulation, vessel endothelial function, and angiogenesis (Chen, Lee, et al, 2016;Chen, Yang, et al, 2016;Lo et al, 2019;Yu et al, 2006). Indeed, research has shown that FIR therapy reduces atherosclerosis in humans (Chen, Lee, et al, 2016;Chen, Yang, et al, 2016;Choi et al, 2016;Lo et al, 2019;Yu et al, 2006). Due to FIR's ability to increase vasodilation, improve vascular endothelial cell function, slow the inflammatory response, and reduce endothelial oxidative stress in addition to evidence that it stimulates skeletal muscle cell migration mediated by platelet-derived growth factor and tissue healing (Lee et al, 2019), clinicians have used such treatment widely to treat hemodialysis fistulas (Lee et al, 2019).…”

“…Both the autonomic nervous system and NO (Gribbe et al, 2007;Yu et al, 2006) have critical roles in maintaining blood perfusion of the skin. But while clinical reports have investigated the FIR dose needed to improve dialysis treatment for patients with an arteriovenous fistula (Hsu et al, 2019;Lo et al, 2019), few have investigated the effects of FIR on foot circulation, and evidence showing that FIR therapy could improve blood circulation in the feet among patients with diabetes undergoing hemodialysis is scarce. The aim of the present study, then, was to examine whether the application of FIR to the feet can increase the microcirculation of the skin, decrease ischemic pain, improve the sense of touch, and reduce discomfort in patients with diabetes undergoing hemodialysis.…”

Intimal Hyperplasia and Arteriovenous Fistula Failure: Looking Beyond Size Differences

“…The rest are currently not recommended by the Kidney Disease Outcomes Quality Initiative guidelines due to lack of phase 3 studies (Optiflow) or significant benefits in AVF outcomes (ECs, elastase) (15). Far infrared radiation and external pneumatic compression (Fist Assist) have shown promising results in AVF maturation parameters (120)(121)(122)(123) and secondary patency after PTA in specific patient demographics (124), but require further validation in a broader hemodialysis population. These clinical trials illustrate the desire to innovate in the search for preventive and postoperative AVF treatments.…”