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Meta-Analysis
. 2014 Aug 12;9(8):e104931.
doi: 10.1371/journal.pone.0104931. eCollection 2014.

Role of far infra-red therapy in dialysis arterio-venous fistula maturation and survival: systematic review and meta-analysis

Khalid Bashar  1 , Donagh Healy  1 , Leonard D Browne  2 , Elrasheid A H Kheirelseid  1 , Michael T Walsh  2 , Mary Clarke-Moloney  1 , Paul E Burke  1 , Eamon G Kavanagh  1 , Stewart Redmond Walsh  3
Affiliations
Meta-Analysis

Role of far infra-red therapy in dialysis arterio-venous fistula maturation and survival: systematic review and meta-analysis

Khalid Bashar et al. PLoS One. .

Abstract

Introduction: A 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.

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA 2009 Flow Diagram.
Figure 2
Figure 2. Forest Plot showing Primary AVFs patency at 12 months.
Figure 3
Figure 3. Funnel plot for Primary AVFs patency at 12 months.
Figure 4
Figure 4. Forest Plot showing Primary AVFs patency at 12 months, Lin et al RCT on new AVFs excluded.
Figure 5
Figure 5. Forest plot showing assisted patency rates at 12 months.
Figure 6
Figure 6. Forest plot showing surgical intervention for AVF malfunction.
See this image and copyright information in PMC

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