EFFICACY OF FAR-INFRARED THERAPY ON VASCULAR ACCESS PATENCY IN HEMODIALYSIS PATIENTS: AN OPEN-LABEL RANDOMIZED CONTROLLED TRIAL IN A TERTIARY HOSPITAL IN THE PHILIPPINES

 

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https://storage.unitedwebnetwork.com/files/1099/d363c8b6cd6d15410f7587cdfd0b38df.pdf
EFFICACY OF FAR-INFRARED THERAPY ON VASCULAR ACCESS PATENCY IN HEMODIALYSIS PATIENTS: AN OPEN-LABEL RANDOMIZED CONTROLLED TRIAL IN A TERTIARY HOSPITAL IN THE PHILIPPINES

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Maribel Jane
Hortelano
Maribel Jane Hortelano bellegavilan@gmail.com St. Luke's Medical Center Global City Center for Renal Diseases Taguig City Philippines *
Annabelle Sy-Lim asylim@stlukes.com.ph St. Luke's Medical Center Global City Center for Renal Diseases Taguig City Philippines -
Rachele Dacillo racheledacillo@gmail.com St. Luke's Medical Center Global City Center for Renal Diseases Taguig City Philippines -
Jonathan James Bernardo jbernsmd@gmail.com St. Luke's Medical Center Global City Heart and Vascular Institute Taguig City Philippines -
Jennylyn Mangulabnan jennylynmangulabnan@yahoo.com St. Luke's Medical Center Global City Heart and Vascular Institute Taguig City Philippines -
 
 
 
 
 
 
 
 
 
 

Among patients maintained on hemodialysis, an effective and well-functioning vascular access is crucial for successful dialysis treatment. There is a limited data on how to prevent stenosis and extend the lifespan of arteriovenous fistula (AVF) and arteriovenous graft (AVG). This study aims to evaluate the efficacy of far-infrared therapy in maintaining over-all patency of AVF and AVG.

Open-label randomized controlled trial involving adult chronic dialysis patients with a functioning AVF and AVG. Intervention group received 40 minutes of far-infrared therapy 3 times weekly for 9 months. The control group did not receive any treatment other than routine hemodialysis. The outcome measurements are: change in vein diameter in millimeter (mm), peak systolic velocity (PSV) in meters/second (m/s), and access blood flow measured in ml/min using duplex ultrasound measured at baseline, 6th month treatment, and 9th month treatment. The incidence of access malfunction was also compared between the two groups.

Total of 26 participants were randomly allocated in the treatment group (n=13) and control group (n=13). Baseline characteristics are similar between the two groups. Compared to the control group, patients in the treatment group have slight increase in vein diameter at 6 months (0.02mm vs -0.02mm, p=0.21) and at 9 months (0.1mm vs -0.1mm, p=0.21), an increase in PSV at 6 months (39.3m/s vs 1.7m/s, p=0.44) and decrease in PSV at 9 months (-1.2m/s vs 11.5m/s, p=0.75), and an increase in access blood flow at 6 months (51.2ml/min vs -0.7ml/min, p=0.40) and at 9 months (80.1ml/min vs -14.2ml/min, p=0.17). There is also lower incidence of access malfunction in the intervention group (7.7% vs 15.4% p=1.0). These, however, are all statistically not significant due to low sample size.

Far-infrared therapy improves vascular access patency by increasing vascular access blood flow for both AVG and AVF and by slightly increasing vein diameter, and has less incidence of access malfunction, although these findings are statistically not significant due to its limited sample size. More studies with larger sample size are needed to increase its statistical power and generalizability of results.

Kewords