TY - JOUR
T1 - Role of far infra-red therapy in dialysis arterio-venous fistula maturation and survival
T2 - Systematic review and meta-analysis
AU - Bashar, Khalid
AU - Healy, Donagh
AU - Browne, Leonard D.
AU - Kheirelseid, Elrasheid A.H.
AU - Walsh, Michael T.
AU - Clarke-Moloney, Mary
AU - Burke, Paul E.
AU - Kavanagh, Eamon G.
AU - Walsh, Stewart Redmond
PY - 2014/8/12
Y1 - 2014/8/12
N2 - Introduction: A well-functioning arteriovenous fistula (AVF) is the best modality for vascular access in patients with endstage 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. Method: We 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. Results: Four 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). Conclusion: FIR 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.
AB - Introduction: A well-functioning arteriovenous fistula (AVF) is the best modality for vascular access in patients with endstage 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. Method: We 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. Results: Four 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). Conclusion: FIR 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.
UR - http://www.scopus.com/inward/record.url?scp=84905818182&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0104931
DO - 10.1371/journal.pone.0104931
M3 - Article
C2 - 25115802
AN - SCOPUS:84905818182
SN - 1932-6203
VL - 9
JO - PLoS ONE
JF - PLoS ONE
IS - 8
M1 - e104931
ER -