Abstract
IntroductionA 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.MethodWe 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.ResultsFour 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).ConclusionFIR 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.
Highlights
A well-functioning arteriovenous fistula (AVF) is the best modality for vascular access in patients with endstage renal disease (ESRD) requiring haemodialysis (HD)
The two studies which reported secondary patency rates showed significant difference in favour of Far Infrared (FIR) therapy160/168 patients - compared to 140/163 controls
FIR therapy may positively influence the complex process of AVF maturation improving both primary and secondary patency rates
Summary
A well-functioning arteriovenous fistula (AVF) is the best modality for vascular access in patients with endstage renal disease (ESRD) requiring haemodialysis (HD). 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. The number of patients with end stage renal disease (ESRD) requiring haemodialysis (HD) is steadily rising, a trend that is expected to continue [1]. Vascular access is a critical component in successful HD. A well-functioning arteriovenous fistula (AVF) is the best modality for HD vascular access [2,3,4,5,6]. The need for re-intervention to maintain patency should be minimal [2,3,4,6,7]
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