The effect of far infrared radiation on maturation in arteriovenous fistulas in patients on hemodialysis: A randomized controlled, multicenter trial.

INTRODUCTION

Improved arteriovenous fistula (AVF) maturation is crucial for reducing the dependency on central venous catheters in patients undergoing hemodialysis (HD). Far-infrared radiation (FIR) is a treatment modality that may enhance maturation and patency. The present trial examined the effect of FIR on newly placed AVFs. The hypothesis was that FIR treatment on the AVF would improve maturation and patency after 12 months compared to a control group.

METHODS

Patients were randomized to receive FIR treatment or no FIR. After AVF placement, the FIR group received FIR on the skin of their AVF for 40 min at every HD treatment for 1 year. The primary outcome was the difference in maturation (time to cannulation), which was expressed as a median and compared with the Mann-Whitney U test. It was furthermore explored as a hazard ratio (HR) determined by Cox regression analysis. Differences in the number of patients with AVF thrombosis and primary patency at 3 months were explored in a Chi-square test.

RESULTS

A total of 91 patients were randomized to either FIR (n = 46) or the control group (n = 45). There were no differences in baseline characteristics between groups. No difference in time to cannulation was found (64 days [47; 96] in the FIR group and 69 days [57; 85] in the control group, p = 0.89). The HR for cannulation was 0.82 (95% confidence interval (CI), 0.50-1.34, p = 0.42) in the FIR group compared to the control group. There was no difference in patients with AVF thrombosis (p = 0.32) or primary patency at 3 months (p = 0.17).

CONCLUSION

We did not find that FIR had a beneficial effect on maturation (time to cannulation) or overall patency between treatment groups in newly placed AVFs in patients undergoing HD. (Clinicaltrials.gov: NCT04011072).