far-infrared

FIRAPY Debuts at WHX Dubai 2026 with a Focus on Innovative Care for Dialysis Patients

Thu, 12 Feb 2026 06:56:44 GMT

On 9–10 February 2026, FIRAPY joined Unex Corporation (Japan) at World Health Expo – WHX Dubai 2026, held at the Dubai Exhibition Centre, Expo City Dubai. This was FIRAPY’s first time participating in WHX Dubai, marking an important step in expanding our presence in the Middle East and surrounding regions.

WHX Dubai (World Health Expo) is one of the region’s most important healthcare exhibitions, bringing together thousands of healthcare professionals, industry leaders, and innovators from more than 100 countries. The event combines a large-scale trade show with conferences and forums that highlight new technologies, clinical best practices, and emerging models of care.

Within the shared exhibition area, FIRAPY and Unex each showcased their own products and solutions .

FIRAPY’s booth focused on the theme:

“An Innovative Therapy for Dialysis Patients”

Visitors could see how FIRAPY is applied in real-world dialysis units through photos, clinical examples, and on-site discussions about workflow integration and patient selection.

Unex, meanwhile, presented its own FMD technologies, giving visitors a broader view of innovation in vascular care coming from Japan and Taiwan.

Strong Interest from Emerging and Established Markets

During the first two days of WHX Dubai, the FIRAPY booth welcomed a continuous stream of visitors, including distributors and potential partners from India, Italy, Pakistan, Morocco, Bosnia and Herzegovina, the United Arab Emirates, Saudi Arabia, Lebanon, and Libya .

Discussions covered:

How to introduce FIRAPY as a non-invasive option for vascular access care
Integration into existing dialysis workflows and staffing patterns
Evidence from international guidelines and clinical studies
Opportunities for pilot projects and local clinical evaluation

We were deeply impressed by the energy of the exhibition and the proactive engagement of attendees . Many visitors came prepared with detailed questions about clinical outcomes, patient selection, and implementation in both public and private dialysis centers—turning booth visits into serious, project-oriented conversations.

We are grateful to all the clinicians, distributors, and industry colleagues who visited our booth, and to Unex for sharing the exhibition space in Dubai. FIRAPY remains committed to bringing evidence-based, practical, and patient-friendly FIR therapy to dialysis patients worldwide.

FIRAPY’s First Clinical Report Published in Oman

Mon, 29 Dec 2025 03:54:27 GMT

Authors: Hamed Ali Ahmad Alshahri, Omaima Farah Al Jabal
Published in: World Advances in Renal Medicine Vol.1, No.3 (2025)
Read the full article

We are proud to share that Mr. Hamed Ali Ahmad Alshahri , a dialysis nurse at Sultan Qaboos Hospital in Salalah, Oman , has published the first FIRAPY-related case report from Oman , marking an exciting milestone for FIRAPY’s expanding global footprint.

The case report, titled “Far-infrared therapy improved vascular access blood flow in a hemodialysis patient: a case report from Oman,” was published in World Advances in Renal Medicine , the official open-access, peer-reviewed journal of the Oman Society of Nephrology and Transplantation (OSNT) .

Published in World Advances in Renal Medicine—the official journal of the Oman Society of Nephrology and Transplantation —the case highlights FIRAPY’s ability to promote healing of a non-healing ulcer near the vascular access site . Over the course of regular non-invasive therapy, the patient’s wound showed improvements in granulation, inflammation control, and healing progression, offering new hope in the management of chronic wounds in dialysis patients.

Mr. Hamed’s journey with FIRAPY began in 2016 , when he was pursuing his master’s degree in the UK. During his clinical training at the New Cross Hospital in Wolverhampton , he encountered FIRAPY in use and was impressed by its impact on hemodialysis patients. In 2019 , while continuing his academic training at Cardiff University , he again saw FIRAPY in practice at multiple dialysis centers, reinforcing his belief in its clinical benefits.

In 2021 , upon returning to Oman, Mr. Hamed introduced FIRAPY into the local medical system by contacting FIRAPY team. As an active member of the Oman Society of Nephrology and Transplantation , he has also taken steps to share this innovative therapy with the broader nephrology community in Oman.

We are honored to support dedicated professionals like Mr. Hamed, who bring global innovations to local patient care. His work reflects FIRAPY’s mission: to empower healthcare providers worldwide with safe, evidence-based solutions that improve dialysis outcomes and patient quality of life.

We thank Mr. Hamed for his pioneering contribution and look forward to future collaborations in the Middle East and beyond.

FIRAPY Showcases at the Chilean Society of Nephrology Annual Congress, Expanding Clinical Exchange in Latin America

Wed, 03 Dec 2025 07:06:16 GMT

Date: November 26–29, 2025
Location: Viña del Mar, Chile
Organized by: Sociedad Chilena de Nefrología (Chilean Society of Nephrology)
Official website: https://congreso.nefro.cl/

FIRAPY recently participated in one of the key nephrology events in Latin America—the 42nd Annual Congress of the Chilean Society of Nephrology (XLII Congreso Chileno de Nefrología, Hipertensión y Trasplante Renal), held from November 26 to 29, 2025, in the coastal city of Viña del Mar. The event brought together nephrologists, dialysis care professionals, and healthcare leaders from across Chile and neighboring countries.

FIRAPY was showcased by its local distributor, Mirusta Spa Chile , with a dedicated exhibition booth highlighting FIRAPY’s applications in vascular access care . On-site demonstrations and clinical discussions were led by Victor Gómez Pavez , a physical therapist representing FIRAPY in Chile. The booth attracted strong interest from nephrologists and care teams, with several medical institutions requesting trial information and partnership opportunities.

A notable highlight was Victor’s invited presentation at the congress workshop titled “Taller de evaluación y manejo de fístula” (Workshop on AV Fistula Assessment and Management) . The invitation came directly from the congress executive director. During the session, Victor introduced FIRAPY’s non-invasive mechanism, international clinical use cases, and potential benefits in improving AV fistula function—marking the first time FIRAPY was formally featured in an academic workshop in Chile.

This successful participation not only marked FIRAPY’s first public debut in Chile , but also set the stage for future clinical collaborations in Latin America. FIRAPY Medical sincerely thanks the Chilean Society of Nephrology and the dedicated Mirusta Spa Chile team for their support and coordination. We look forward to building more partnerships across South America in advancing patient-centered vascular care.

FIRAPY Forum 2025 – Holistic Care for Dialysis Patients: Makes Life Better

Fri, 28 Nov 2025 04:58:49 GMT

We are pleased to share that the FIRAPY Study Club will host its first international FIRAPY Forum on December 6, 2025 (Saturday) , in conjunction with APCN × TSN 2025 in Taipei. The Forum will take place from 13:30–16:15 , Room 603, 6F, Taipei Nangang Exhibition Center, Hall 2 (TaiNEX 2) .

Under the theme “Holistic Care for Dialysis Patients: Makes Life Better,” the Forum will bring together nephrology experts from Taiwan, Japan, Korea, Malaysia, Thailand, and Indonesia to share the latest scientific evidence and real-world experience in far-infrared therapy (FIR therapy) for dialysis patients—covering vascular access care, dialysis management, and long-term outcome improvement.

We are deeply honored that WS FAR IR Medical is serving as a sponsor of the FIRAPY Forum . Together with our partners, we are also supporting Booth A38 in the APCN exhibition area as the Forum reception point, where participants can pre-register, ask questions, and continue discussions with the Secretariat team throughout the congress.

How to Join

Date: December 6, 2025 (Saturday)

Time: 13:30–16:15

Venue: Room 603, 6F, Taipei Nangang Exhibition Center, Hall 2 (TaiNEX 2), Taipei

Registration: Free entry with pre-registration at Booth A38 in the APCN exhibition area

We warmly invite all colleagues attending APCN × TSN 2025 who are interested in dialysis care, vascular access, and non-invasive supportive therapies to join us at the FIRAPY Forum 2025 .

Come meet the experts, hear the latest FIR evidence, and explore how FIRAPY can contribute to better vascular access, better dialysis care, and better lives for patients .

FIRAPY Featured at the 24th JSVMR Annual Meeting with a Special Symposium and Two Research Presentations

Sun, 02 Nov 2025 08:13:37 GMT

On November 2, 2025 , FIRAPY was honored to participate in the 24th Annual Meeting of the Japan Society of Vascular Medicine and Rheology (JSVMR) , held at Saitama Medical Center of Dokkyo Medical University . The JSVMR is a prominent academic society composed mainly of professionals in cardiovascular and vascular medicine, focusing on advancements in hemodynamics, vascular biology, and innovative, non-invasive therapeutic approaches.

This year marked FIRAPY’s first official presence at JSVMR , with both a product exhibition booth and a lunch symposium that sparked strong engagement from the academic community.

A highlight of the event was the FIRAPY-sponsored lunch symposium , where Professor Yukihito Higashi of Hiroshima University—an esteemed researcher and New England Journal of Medicine contributor—was invited to deliver a keynote presentation. Professor Higashi gave a comprehensive overview of FIRAPY’s more than decade-long clinical and research history in Japan, and outlined important directions for future studies in vascular applications of far-infrared therapy.

In addition, two FIRAPY-related studies were presented during the conference:

"The Effect of Combined Neuromuscular Electrical Stimulation and Far-Infrared Therapy on Peripheral Circulation in Healthy Subjects"
Presented by Dr. Shota Sugai, this pilot study explored the synergistic effects of NMES and FIRAPY on improving peripheral circulation in healthy individuals. With Dr. Yasu Takanori (this year’s JSVMR Congress Chair) listed as a senior co-author, the study opens new possibilities in non-invasive approaches for vascular health.
"Far-Infrared Radiation Promotes the Expression of Angiogenesis-Related Genes"
Presented by Dr. Makoto Saito , this research provided molecular-level insights into FIRAPY’s role in upregulating angiogenesis-related gene expression, supporting its use in vascular regeneration and wound healing.

Thanks to Professor Higashi’s powerful lecture and the contributions of Dr. Sugai and Dr. Saito , FIRAPY’s booth received considerable attention throughout the event. Professor Higashi and Dr. Saito gathered at the booth to exchange insights on clinical usage, research findings, and potential applications of FIRAPY. Their conversations also laid the foundation for future collaborative research projects .

FIRAPY Medical sincerely appreciates the opportunity to support and participate in this respected scientific event, and remains committed to advancing non-invasive solutions in vascular and renal care—guided by academic evidence and clinical collaboration.

FIRAPY Gains Momentum at the 70th JSDT Annual Meeting with 11 Research Presentations

Wed, 16 Jul 2025 08:28:00 GMT

FIRAPY Medical Japan proudly participated in the 70th Annual Meeting of the Japanese Society for Dialysis Therapy (JSDT) , held in Osaka from June 27 to 29, 2025 . This year marked a major milestone for FIRAPY in Japan: a total of 11 FIRAPY-related research presentations were featured during the congress—showcasing growing academic interest in far-infrared therapy as a supportive, non-invasive treatment in dialysis care.
represents a significant milestone in FIRAPY’s ongoing academic engagement in dialysis-related research.

The presentations, led by clinical teams across Japan, explored a wide range of practical topics such as:

Puncture-related pain relief
Improvement of vascular access function
Blood flow and surface temperature changes in the limbs
Adjunctive use of FIRAPY with compression therapy
Foot care and chronic wound management
Skin perfusion pressure post-thermal therapy

This broad spectrum of research reflects FIRAPY’s clinical versatility and relevance to front-line dialysis professionals. Many visitors to the FIRAPY booth expressed that they were drawn by hearing or seeing the scientific presentations, and were eager to explore how FIRAPY can address common vascular access issues and improve patient outcomes.

As a result, the FIRAPY booth welcomed a continuous stream of visitors throughout the event. In addition to learning about FIRAPY’s mechanism and application in vascular care, clinicians also discussed its growing role in chronic wound management and travel dialysis support . Through FIRAPY’s global network, we are proud to uphold our social responsibility by helping dialysis patients travel more freely and maintain a better quality of life.

The increasing number of academic studies reflects Japan’s growing enthusiasm in validating FIRAPY’s role in dialysis. FIRAPY Medical remains committed to supporting clinician-led research and delivering patient-centered, evidence-based innovations in renal therapy.

We sincerely thank all the researchers, healthcare professionals, and partners who contributed to this progress. We look forward to continued collaboration in the pursuit of better outcomes for patients.

FIRAPY Supports Clinical Research Advancing Non-Invasive Therapies for Peritoneal Dialysis

Wed, 02 Jul 2025 06:06:02 GMT

We are pleased to share that a new peer-reviewed clinical study, conducted in collaboration with Taipei Veterans General Hospital , has been published in the Journal of the Formosan Medical Association (JFMA, 2025).
The study, titled
“ Far-infrared therapy improves cardiovascular and infectious outcomes in peritoneal dialysis patients: A propensity-score matched cohort study ,”
represents a significant milestone in FIRAPY’s ongoing academic engagement in dialysis-related research.

Long-Term Collaboration to Explore Non-Invasive Therapeutic Strategies

Over the past several years, the FIRAPY team has actively collaborated with hospital-based research groups and nephrology departments to support the development of non-invasive therapeutic approaches for dialysis patients. These joint research efforts have focused on key challenges in peritoneal dialysis, including:

Inflammatory burden
Cardiovascular complications
Peritoneal membrane function
Infection-related outcomes

This newly published study marks the sixth peer-reviewed paper supported by FIRAPY in this field and underscores our ongoing commitment to advancing scientific research that aims to improve patient outcomes through non-invasive care modalities .

About the Latest Publication

Led by the nephrology team at Taipei Veterans General Hospital , the study employed a propensity score-matched cohort design to evaluate long-term outcomes in peritoneal dialysis patients. The results suggest that the use of far-infrared therapy may be associated with reduced cardiovascular and infectious complications , offering promising insights for future clinical exploration.

We extend our sincere thanks to the research team at TVGH for their dedication and leadership, and we look forward to continuing our support for high-quality, collaborative research in kidney care.

Far-infrared therapy improves cardiovascular and infectious outcomes in peritoneal dialysis patients

Wed, 02 Jul 2025 05:40:41 GMT

Abstract

Introduction

While far-infrared (FIR) therapy has improved the treatment of various diseases, its effects on peritoneal dialysis (PD) remain understudied. The study aims to investigate the impact of FIR therapy on the cardiovascular and infectious outcomes in PD patients.

Methods

A prospective observational study was conducted for six months, comparing a group receiving FIR therapy (n = 49) with a control group (n = 50). The primary outcome is defined as the composite outcome of three-point major adverse cardiovascular events (3P-MACE), coronary artery disease (CAD), congestive heart failure (CHF), or PD-related infection. The secondary outcomes are: (1) 3P-MACE; (2) 3P-MACE, CAD, or CHF; (3) PD-related infection.

Results

The FIR group consistently exhibited lower incidence rates for primary and secondary outcomes. The primary outcome occurred in six patients (12.2 %) in the FIR group and 15 patients (30 %) in the control group, with incidence rates of 0.26 vs. 0.75 events per patient-year, respectively (p = 0.03). The secondary outcomes for the FIR and control groups were: (1) 3P-MACE occurred in zero patients and four patients (8 %), respectively; (2) composite outcome of 3P-MACE, CAD, or CHF occurred in two patients (4.1 %) and six patients (12 %), respectively; (3) PD-related infection occurred in six patients (12.2 %) and 12 patients (24 %), respectively. Furthermore, FIR therapy significantly reduced hospitalizations for the primary outcome (HR = 0.22; 95 % CI = 0.07–0.71; p = 0.01) and demonstrated better survival rate at six months (85.7 % vs. 67.9 %, respectively). Conclusion: This study suggests that FIR therapy shows promise in reducing hospitalizations associated with cardiovascular and infectious outcomes in PD patients.

-J Formos Med Assoc. 2025 May 26:S0929-6646(25)00239-6

FIRAPY to Exhibit at 70th JSDT Annual Meeting in Yokohama

Tue, 17 Jun 2025 10:26:40 GMT

We are pleased to announce that FIRAPY will be exhibiting at the 70th Annual Meeting of the Japanese Society for Dialysis Therapy (JSDT) , to be held in OSAKA , Japan , from June 27-29, 2025 .

�� Booth No.: ⑩-96
�� June 27–29, 2025
�� Osaka International Convention Center
�� Event Website (Japanese)

FIRAPY is now adopted by over 200 dialysis facilities across Japan , where it has been used in daily clinical practice to support fistula function maintenance and foot care . With this extensive local experience, FIRAPY has become an important part of non-invasive treatment for Japanese HD patients.

We look forward to sharing our latest clinical insights and field experiences at JSDT 2025.

If you are attending, we warmly welcome you to stop by Booth ⑩-96 and learn more about how FIRAPY is making a difference in dialysis care.

See you in Osaka!

FIRAPY Showcased at ERA 2025 in Vienna

Sun, 08 Jun 2025 08:23:30 GMT

FIRAPY Medical was honored to exhibit at ERA 2025 , held at Austria Center Vienna from June 4–7, 2025 . This event marked FIRAPY’s first return to the ERA Congress since the global COVID-19 pandemic , and an important milestone in reconnecting with the European nephrology community.

During the congress, our booth (X1.200) attracted considerable attention from both existing partners and new contacts. We were very encouraged by the many productive conversations and the strong interest shown by nephrology professionals across different regions.

It was a great pleasure to meet some of our long-standing friends at the event, including:

Stanningley Pharma (UK) — our valued distribution partner in the UK for more than 15 years
Dr. Dan Heristea (France) — a nephrology expert and friend of FIRAPY
Nordic MedCom (Nordic) — a familiar face from past interactions in the industry

We were equally pleased to engage with potential new partners from Canada, Morocco, Panama, and the UAE . We look forward to the possibility of building new collaborations to further extend the clinical benefits of FIRAPY to more patients worldwide.

We sincerely thank everyone who visited our booth and supported us throughout the congress. We look forward to continuing these conversations and working together to advance vascular access care and patient outcomes through FIRAPY.

FIRAPY Expands Local Engagement in Thailand Through Two Key Vascular Access Events

Mon, 26 May 2025 06:52:10 GMT

In April and May 2025, FIRAPY, together with our Thailand partner K2 Medical , participated in two important regional events to promote far-infrared therapy’s growing role in vascular access care.

First Step to Vascular Access Care Workshop – Chiang Mai

On April 4, 2025 , FIRAPY was featured at the First Step to Vascular Access Care Chiang Mai 2025 , hosted by the Department of Surgery, Faculty of Medicine, Chiang Mai University . Held in Chiang Mai, Thailand , the workshop attracted healthcare professionals from across Northern Thailand.

At Booth No. 2 , K2 Medical presented FIRAPY’s clinical benefits in improving vascular access function and preventing complications in hemodialysis patients. A key moment during the event was a live demonstration for Professor Dr. Kittipan Rerkasem, M.D., Ph.D. , Head of the Vascular Surgery Unit at Maharaj Nakorn Chiang Mai Hospital, which opened further discussions on FIRAPY’s potential applications beyond dialysis.

“Are Your Kidneys OK?” Kidney Health Awareness Event – Bangkok

On May 23, 2025 , FIRAPY participated in another important public health event, “Are Your Kidneys OK? Detect Early, Protect Kidney Health” , organized by the Nephrology Society of Thailand in Bangkok . This event focused on early detection and protection of kidney function, attracting a wide range of healthcare providers and public attendees.

At this event, the K2 Medical team once again introduced FIRAPY’s application in supporting long-term vascular access management for dialysis patients. The exhibition drew strong attention from both nephrology professionals and nurses, highlighting FIRAPY’s relevance in daily clinical practice and its potential for broader application in chronic kidney care.

Both events provided valuable opportunities to connect directly with frontline healthcare providers, from surgeons to dialysis nursing teams, reinforcing FIRAPY’s positioning as a non-invasive, guideline-supported solution for vascular access care . We sincerely thank K2 Medical for their continued efforts to expand FIRAPY’s presence and impact in Thailand’s dialysis care community.

FIRAPY at ERA 2025 – See You in Vienna!

Fri, 23 May 2025 07:24:04 GMT

We’re excited to announce that FIRAPY will be exhibiting at the 62nd ERA Congress in Vienna from June 4–7, 2025 !

�� Booth No.: X1.200
�� June 4–7, 2025
�� Austria Center Vienna

This marks FIRAPY’s first European event since the COVID-19 pandemic , making it a special occasion for us to reconnect with partners and professionals across the continent.

This year’s congress theme, “Game Changers in Nephrology,” aligns perfectly with FIRAPY’s mission to enhance dialysis care through innovative vascular access management.

We look forward to seeing old friends and new collaborators who share our commitment to improving outcomes for dialysis patients. Whether you're already using FIRAPY or exploring its clinical potential, we warmly invite you to visit our booth and connect with our team.

Let’s explore how far-infrared therapy is transforming the future of vascular access—together.

FIRAPY Joins Dialysis Weekend 2025 in Pattaya with K2 Thailand

Fri, 23 May 2025 07:07:01 GMT

From February 28 to March 1, FIRAPY was honored to participate in Dialysis Weekend 2025 in Pattaya, Thailand, at the invitation of our valued partner K2 Thailand . This annual event, hosted by the Nephrology Society of Thailand ( event site ), is a key gathering for nephrology professionals across the country.

This occasion marked a milestone for K2 Thailand, as their entire dialysis sales team made their first collective public appearance alongside FIRAPY. The team’s strong presence and professionalism drew significant attention from both clinicians and industry attendees, highlighting the growing interest in FIRAPY's role in dialysis care.

A special highlight of the event was the visit from Dr. Suki , a well-known figure in the international nephrology community ( WCN profile ). Dr. Suki stopped by the K2 booth to personally show support and encouragement to the team, reinforcing the collaboration and shared mission of improving vascular access outcomes for dialysis patients.

We thank K2 Thailand for their partnership and dedication, and look forward to continuing our journey together in advancing FIRAPY’s impact across Southeast Asia.

FIRAPY Presented at Thai Vascular Surgery Forum 2025

Fri, 21 Mar 2025 09:43:07 GMT

On March 4-6, 2025 , our Thailand distributor K2 Medical represented FIRAPY at the event “Practical Approaches in Vascular Surgery for General Surgeons,” organized by the Thai Vascular Association in Bangkok, Thailand .

FIRAPY was showcased at Booth No. 24 , where the K2 Blood Purification Division sales team introduced the clinical value of FIR therapy to vascular surgeons and healthcare professionals.

Notably, the K2 sales team is composed of experienced dialysis nurses and medical engineers , enabling them to deliver both clinical and technical perspectives on FIRAPY’s use in vascular care.

The exhibition focused on how FIRAPY promotes vascular access function and maturation , drawing strong interest from attendees and generating meaningful discussions.

One highlight of the day was a visit from a vascular surgeon who expressed interest in FIRAPY’s potential in treating arterial insufficiency —a promising signal of future applications beyond dialysis.

We sincerely thank the K2 team for their continued dedication in expanding FIRAPY’s clinical reach across the vascular community in Thailand.

Join Us at the Taiwan Healthcare+ Expo 2024

Mon, 02 Dec 2024 07:22:21 GMT

Meet FIRAPY at Booth i1115a!

We are thrilled to announce our participation in the Taiwan Healthcare+ Expo 2024 , Asia's leading platform for healthcare innovation and technology.

�� Date : November 30 - December 3, 2024
�� Time : 10:00 AM – 6:00 PM (last day until 4:00 PM)
�� Location : Taipei Nangang Exhibition Center, Hall 1
��️ Booth Number : i1115a

At this year's expo, we will be showcasing FIRAPY , our groundbreaking non-invasive therapy device , scientifically proven to improve vascular access function, relieve peripheral ischemia, and support wound healing. Recognized by clinical guidelines and trusted by medical professionals, FIRAPY is designed to elevate patient outcomes while simplifying clinical workflows.

If you are passionate about improving dialysis care, vascular health, or exploring innovative healthcare solutions, we warmly invite you to visit us at Booth i1115a . Our team of experts will be on-site to answer your questions, provide live demonstrations, and discuss how FIRAPY can benefit your practice.

Don't miss this opportunity to explore the future of healthcare with us!

For more information about the Taiwan Healthcare+ Expo, visit expo.taiwan-healthcare.org .

We look forward to meeting you there!

Improved Conditions of Couple Receiving Hemodialysis

Tue, 26 Nov 2024 07:22:14 GMT

Patient: Mr. & Mrs. Qiu

Medical history: Hemodialysis patients, 2 years

Symptoms: Extremely fine blood vessels

Hospital: Tao* Clinic, Taoyuan

I am 55 years old and I own a Chinese Traditional Medicine Shop. I have been on hemodialysis for 2 years now. In the past year, I have been troubled by insomnia. I go for my hemodialysis twice a week and I am able to sleep on these 2 days. But I frequently have problems sleeping on the days when hemodialysis was not performed. Sometimes I go hiking in Hutou Mountain Park and even go swimming to make myself sweat. But even then, I find myself unable to go to sleep all night.

To relieve my insomnia, I started to take tranquilizers every day. Although I am worried about the side effects of long-term consumption of tranquilizers, I have no choice. I grieve on non-hemodialysis days when insomnia is a misery for me. I don’t know what to do.

Wife: Improvements in fine blood vessels

My wife is also a hemodialysis patient. Her blood vessels were too fine and created problems for her dialysis. For two years, she had been using Firapy (WS™ Far-infrared Therapy Unit) in the hospital regularly and her conditions improved gradually. To save time traveling to and from the hospital, we bought the device and started self-management at home.

Before that, she had to go for angioplasty to solve the problems with her fistula. Her condition, however, greatly improved after she used Firapy (WS™ Far-infrared Therapy Unit). Her blood flow became stronger; and instead of using the device daily, she only uses it once every other day. Now she doesn’t have to worry about having to go for an operation again.

Husband: Doesn’t require surgery anymore

As for me, I use Firapy (WS™ Far-infrared Therapy Unit) on the fistula at home whenever there are problems with my dialysis. I am proud to say that this is the reason why I did not need an operation or angioplasty after 2 years of hemodialysis.

My aunt is 74 years old and she is also a hemodialysis patient. She has dull veins and she underwent angioplasty last year. After her operation, I suggested that she come to my house to try out Firapy (WS™ Far-infrared Therapy Unit). After using it a few times, her fistula condition improved and her hemodialysis became smoother. She is doing very well now.

As we are financially stable, we sometimes invite dialysis friends to use the device at our place. After all, the fistula is an important lifeline for hemodialysis patients. We hope that this will help dialysis patients with vessel access problems and build up their confidence.

Exceptional vascular patency

Tue, 26 Nov 2024 07:21:57 GMT

Patient: Mr. & Mrs. Qiu

Medical history: Hemodialysis patients, 2 years

Symptoms: Extremely fine blood vessels

Hospital: Tao* Clinic, Taoyuan

Wife: Improvements in fine blood vessels

Husband: Doesn’t require surgery anymore

Application experiences in the hemodialysis center

Fri, 08 Nov 2024 04:07:53 GMT

Dr. Yong-Xiang Hong
Taipei Neihu Hong Yong-Xiang Clinic, President
Tri-service General Hospital, Department of Nephrology, Clinic Physician

I operate a private dialysis center in Neihu, Taipei. I endeavor to improve the quality of dialysis, and prolong the life-span and care of the blood vessels in hemodialysis patients. After consulting several senior physicians specializing in nephrology and cardiovascular surgery, and reading through some national and international medical reports, I chose Firapy (WS™ Far-infrared Therapy Unit) as a method to improve fistula quality. Six months into providing the treatment, I have identified the following benefits for the dialysis room:

1. The one-month period following the fistula creation is the optimal period for rehabilitation

The adherence to physician instruction for performing the handgrip rehabilitation exercise during the time between day three to a month after the fistula surgery affects fistula elevation, which is critical for future hemodialysis. However it is difficult for elderly men and women to properly perform the ball-squeeze handgrip exercise because of their fear of pain at the operation site and physical weakness.

Far infrared therapy provides an optimal alternative for vascular rehabilitation. We apply the therapy for 40 minutes during patients’ dialysis sessions on every patient in our dialysis center after their fistula procedures. It is extremely beneficial for blood flow and vein elevation, especially for patients with poor vascular quality, including elderly patients, diabetic patients, bed ridden stroke patients who cannot perform the handgrip maneuver.

2. Decreases venous pressure during hemodialysis

After prolonged hemodialysis, the fistula develops numerous stenotic points, causing a gradual increase in venous pressure during hemodialysis. During dialysis, the venous pressure elevates with increased rate of blood flow; therefore the rate of blood flow has to be decreased to a correspondingly lower venous pressure. However, low blood flow results in inadequate hemodialysis and obstructs the dialyzer. In situations like this, a 40-minute treatment significantly decreases the venous pressure, providing sufficient time to obtain consultation from vascular surgery in treating vascular stenosis.

3. An outstanding therapy for cannulation-related vascular erosion and ulcer, and difficult recovery

In each hemodialysis session, two cannulations are applied to a segment of the fistula, adding up to six cannulations per week and 312 cannulations per year. The number is greater if unsuccessful cannulations by nurses are included. Understandably, when a small segment of blood vessel receives more than 300 punctures per year, the fistula is bound to have a limited life-span despite applying thorough protection. The segment of the fistula eventually develops vascular problems including erosion, ulcer and difficulty in stopping bleeding. Prior to the introduction of the device, the only measure was to terminate the life of the old fistula and consult with a surgeon to create a new fistula. However, Firapy (WS™ Far-infrared Therapy Unit) benefits the eroded, ulcerated, and difficult-to-heal vessels, and prolongs the life-span of the fistula.

Personally, I find these are the most prominent contributions by Firapy (WS™ Far-infrared Therapy Unit) in my dialysis room.

Hemodialysis and Vascular Access

Thu, 07 Nov 2024 15:25:24 GMT

Dr. Chun-Zhong Liu

Jen-Ai Hospital
Head of Nephrology Department,
Hemodialysis Room, Taichung Branch

Mrs. Yang requires routine hemodialysis due to her uremia, one of the diabetic complications. Difficulties in fistula injection were significantly increased because of both innate and acquired problems caused non-functional fistulas and infections. She avoids hemodialysis for the pain caused by the injection, and changes from one hemodialysis center to another. It was heartbreaking for Mr. Yang, a fishing enthusiast, to hear Mrs. Yang to cry out words like “I am sad when the attempts for the injection fail one after another. I wonder if this is how the fish feels with the hook is in its mouth when you go fishing.” Mr. Yang’s never went fishing afterwards.

The Yangs visited Jen-Ai Hospital through a friend’s recommendation. Mr. Yang told me frankly that he believed that all dialysis centers were the same; none of the dialysis nephrologist could do anything about the blood vessels. He is willing to give Jen-Ai a try because they heard that the nursing staffs here are more experienced and have better technique.

I examined Mrs. Yang’s blood vessels. The fistula on her left arm was clogged. It was marred with bruises and was swollen, inflamed, and covered with the needle scars. The fistula on her right arm was newly installed. I could feel the pulse but the blood flow was weak upon auscultation. Her condition was not encouraging and that worried me. Mrs. Yang had a double lumen catheter installed on the right side of her neck for temporary vascular access. She told me that she did not have sufficient blood flow during the hemodialysis (less than 200 cc/min). In addition, the blood pressure in her vein was high, triggering the alarm on the hemodialysis machine to go off whenever she moved, which led to termination of the hemodialysis. Even though she started the hemodialysis earlier than other patients, she was still struggling with procedures while others were already done with their procedure. She was especially uncomfortable about that.

In my opinion, problems with Mrs. Yang’s blood vessels had to be tackled first to improve the quality in dialysis. Not only the vessels should be taken care of, not just the swelling on the left forearm, the newly installed arteriovenous fistula on the right arm should be well maintained. We also needed to think of a way to increase blood flow to the double lumen catheter on her right neck, it would be best if the rate of 250 ~ 300 cc/min can be achieved, so that the clearance rate could be enhanced. For the location where the surgery was performed recently on the right wrist, I decided to use Firapy (WS™ Far-infrared Therapy Unit, a broad spectrum therapeutic device) for the treatment. I asked Mrs. Yang to concentrate on squeezing a ball with her right arm while applying hot compress on the catheter puncture site, and cleaning the site with Hirudoid™ cream.

The device was used every time she came for hemodialysis to irradiate her thighs for 40 minutes, to increase the blood flow of the large veins. The device was also used on her left forearm for 40 minutes, to aid the recovery process of the swollen, painful arm covered with a bad and non-healing puncture wounds to reduce swelling and to promote healing. Given the treatment regimen, the blood flow in both Mrs. Yang’s arms and the double lumen catheter on her right neck improved. Three weeks later, the task given to double lumen catheter was fulfilled with outstanding results and it was removed. In the subsequent dialysis, vascular access was no longer a nightmare for Mrs. Yang and the dialysis nurses. I was also more confident about the therapeutic effects of Firapy (WS™ Far-infrared Therapy Unit).

A couple of months later, Mr. and Mrs. Yang returned to their home in the countryside. Although we have good service and excellent skills in Jen-Ai Hospital, we cannot go home with them. They brought a Firapy (WS™ Far-infrared Therapy Unit) home with them. Mr. Yang was joyous and said, “Although the nephrologists could not grow new blood vessels, they know how to take care of them. They also taught us how to take good care of the blood vessels. It’s a praiseworthy achievement!” I couldn’t help smiling after hearing his comments.

FIRAPY Showcased at OSNT Conference 2024 in Salalah, Oman

Thu, 10 Oct 2024 09:26:25 GMT

FIRAPY Showcased at OSNT Conference 2024 in Salalah, Oman

We are thrilled to share our successful participation in the Second OSNT International Conference held from September 5–7, 2024, in Salalah, Oman. The conference brought together nephrology experts, dialysis clinicians, and healthcare innovators from across the globe to explore cutting-edge solutions in nephrology care.

FIRAPY's journey to Oman is a story of global collaboration. It was first discovered by Mr. Hamed, an OSNT member, during his advanced studies in the United Kingdom. Recognizing its innovative potential, he made it his mission to introduce FIRAPY to Oman, where it is now gaining attention for its ability to improve dialysis fistula function, enhance microcirculation, and address ischemia-related complications.

At our booth, FIRAPY garnered significant interest from attendees eager to learn more about its non-invasive and evidence-based approach to vascular health management. Interactive presentations and in-depth discussions highlighted FIRAPY's inclusion in clinical guidelines and its proven effectiveness in improving outcomes for dialysis patients.

The event also provided us with a unique platform to connect with key opinion leaders and potential distributors, particularly in the MENA region. We extend our gratitude to the OSNT organizing committee, especially Mr. Hamed, for his support and hospitality, as well as to the numerous healthcare professionals who visited our booth.

As FIRAPY continues to make a global impact, we invite healthcare providers and distributors worldwide to join us in transforming vascular therapy. Stay tuned for more updates on upcoming events and innovations!

Far-infrared Therapy for Hemodialysis Patients

Sat, 06 Jan 2024 08:16:59 GMT

Abstract

Although the arteriovenous fistula is considered the best access due to low complications, it faces challenges such as poor maturation rates and patency issues. The present paper describes the current status of far-infrared therapy as a treatment modality to enhance AVF maturation and access survival. The mechanism underlying FIR therapy involves vasodilatory, angiogenesis, and the induction of vasodilation and anti-inflammatory factors. Thermal effect of FIR therapy involve upregulation of endothelial nitric oxide synthase, while non-thermal effects include reduced oxidative stress and improved endothelial function. In conclusion, FIR therapy presents potential benefits for improving vascular access flow and survival.

- JKDA 2023; 6(2): 47-51

Effect of far-infrared radiation therapy on von Willebrand factor in patients with chronic kidney disease

Tue, 31 Oct 2023 09:32:33 GMT

Abstract

Background

Hemostatic abnormality has contributed to vascular access thrombosis in patients with chronic kidney disease (CKD). Previous studies have demonstrated that far-infrared radiation (FIR) therapy can maintain the patency and maturity of arteriovenous fistulas of patients undergoing hemodialysis (HD). However, prolonged access bleeding is observed once FIR is conducted at the end of dialysis. FIR can block the binding of platelet and von Willebrand factor (vWF), a predictor of hemostatic abnormality and vascular access thrombosis.

However, clinical studies exploring FIR and vWF are sparse.

Methods

We recruited 20 HD patients, 21 CKD patients, and 20 controls to examine the alteration of vWF and a disintegrin and metalloproteinase with thrombospondin type 1 repeats 13 (ADAMTS13) following a single 40-min session of FIR therapy. In addition, the alteration of these factors in the HD group was examined following a 40-min FIR session thrice a week for 3 months.

Results

A decreasing trend in the vWF activity-antigen ratio of participants in all groups following a single FIR session was observed. In addition, the ratio in the HD group was significantly lower following 3 months of FIR therapy. The subgroup analysis revealed a consistent trend and multiple regression analysis showed that participants not taking hydroxymethylglutaryl-coenzyme A reductase inhibitor, diabetes mellitus, and higher hemoglobin levels were the significant factors. The alteration of the vWF activity-antigen ratio correlated moderately to that of ADAMTS13 antigen and activity.

Conclusions

FIR may alter the ratio of ultra-large vWF multimers through ADAMTS13, contributing to inhibiting platelet-endothelium interactions of CKD patients.

-Front Med(Lausanne) 2023 Sep 8:10:1268212.

Far infrared treatment on the arteriovenous fistula induces changes in sVCAM and sICAM in patients on hemodialysis

Fri, 01 Sep 2023 14:10:31 GMT

Abstract

Introduction. There is a substantial risk of developing stenosis and dysfunction in the arteriovenous fistula (AVF) in patients on hemodialysis (HD). Far infrared radiation (FIR) is a noninvasive local intervention with a potentially beneficial effect on AVF patency. The underlying mechanism is not clear. It was hypothesized that a single FIR treatment reduces factors of inflammation and promotes endothelial vasodilators in the AVF.

Methods. Forty HD patients with an AVF were included in an open-label intervention study. Patients were randomized to receive either FIR (FIR group) or no FIR (control group). Blood samples were drawn directly from the AVF and from a peripheral vein in the non-AVF arm before (T0) and 40 min after (T40) treatment during a HD session. The changes [median (interquartile range)] in circulating factors of inflammation, endothelial function and vasoreactivity during FIR were measured.

Results. In the AVF a single FIR treatment during dialysis resulted in a significantly diminished decrease in soluble vascular cell adhesion molecule, sVCAM [−31.6 (−54.3; 22.1) vs −89.9 (−121.6; −29.3), P = .005] and soluble intercellular adhesion molecule, sICAM [−24.2 (−43.5; 25.3) vs −49 (−79.9; −11.6), P = .02] compared with the control group. Other factors, such as interleukins, nitrite, nitrate and tumor necrosis factor 1, also declined during dialysis, but with no significant differences related to FIR in either the AVF or the non-AVF arm.

Conclusion. A single FIR treatment attenuated the decrease in sVCAM and sICAM in the AVF compared with a control group during HD. Findings do not support the hypothesis of a vaso-protective effect of FIR. The long-term effects of FIR on the AVF are unknown.

-Nephrol Dial Transplant (2023) 38: 1752–1760

Acute hemodynamic changes during far infrared treatment of the arteriovenous fistula in hemodialysis patients

Fri, 01 Sep 2023 13:17:17 GMT

Abstract

Background: The arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD) treatment and

preservation of a stable vascular access is crucial. Long term Far Infrared Radiation (FIR) has been found to increase

access flow together with an enhanced maturation and patency of the AVF. The acute effects of FIR on access flow have

been sparsely described and the results are contradictory, perhaps due to differences in measurement conditions and

other factors of importance for access flow.

Methods: Twenty patients in HD with an AVF were included. Each patient was randomized to receive either FIR

(FIR group) or no FIR (control group). The acute changes in access flow were investigated in both groups on the

second dialysis day of the week and during the first 1.5 h of the dialysis session. Concomitant changes in hemodynamic

parameters of importance for access flow were also explored.

Results: There was no significant change in access flow in the FIR group compared with the control group (median

(Interquartile Range)) (−10 (−413.8; 21.3) ml/min vs −17.5 (−83.8; 76.3) ml/min, p = 0.58). There was no significant

difference in any of the hemodynamic parameters between the FIR and the control group; cardiac output (−0.7 (−1.2;

−0.2) l/min vs −0.4 (−0.9; 0.1) l/min, p = 0.58), cardiac index (−0.3 (−0.5; −0.1)) l/min/m2 vs −0.3 (−0.4; 0) l/min/m2, p = 0.68),

mean arterial pressure (5.5 (−1.8; 8.4) mmHg vs 1.5 (−3; 6.3) mmHg, p = 0.35) and total peripheral resistance (2 (1.8; 3.4)

mmHg × min/l vs 1 (−0.3; 3.1) mmHg × min/l, p = 0.12).

Conclusion: In this trial, with a highly standardized set-up, one session of FIR did not result in any acute changes in

access flow. This was not due to differences in the hemodynamic parameters between the groups.

-J Vasc Access. 2023 Jul;24(4):739-746.

Far-Infrared Therapy Improves Arteriovenous Fistula Patency and Decreases Plasma Asymmetric Dimethylarginine in Patients with Advanced Diabetic Kidney Disease: A Prospective Randomized Controlled Tria

Thu, 01 Sep 2022 12:32:38 GMT

Abstract

Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase and plays a significant role in the pathogenesis of arteriovenous fistula (AVF) dysfunction. The aim of this study is to evaluate the effect of far-infrared (FIR) therapy on the maturation and patency of newly-created AVFs in patients with advanced diabetic kidney disease (DKD) as well as the concurrent change in plasma ADMA. The study enrolled 144 participants with advanced DKD where 101 patients were randomly allocated to the FIR therapy group (N = 50) and control group (N = 51). Patients receiving FIR therapy had a decreased AVF failure rate within 12 months (16% versus 35.3%; p = 0.027); decreased incremental change of ADMA concentration at the 3rd and 12th month; increased AVF blood flow at the 1st, 3rd, and 12th month; increased 3-month physiologic maturation rate (88% versus 68.6%; p = 0.034); increased 1-year unassisted AVF patency rate (84% versus 64.7%; p = 0.017); and increased clinical AVF maturation rate within 12 months (84% versus 62.7%; p = 0.029) compared to the control group. The study demonstrates that FIR therapy can reduce the incremental changes in plasma ADMA concentration, which may be associated with the improvement of AVF prognosis in patients with advanced DKD.

-J. Clin. Med. 2022, 11, 4168

Does Far-Infrared Therapy Improve Peritoneal Function and Reduce Recurrent Peritonitis in Peritoneal Dialysis Patients?

Fri, 01 Jul 2022 12:44:00 GMT

Abstract

The use of peritoneal dialysis in end-stage renal disease is increasing in clinical practice. The main purpose of this study was to evaluate the effect of far-infrared radiation therapy on inflammation and the cellular immunity of patients undergoing peritoneal dialysis. We recruited 56 patients undergoing peritoneal dialysis, and we included 32 patients for the experimental group and 24 patients from the control group in the final analysis. The experimental evaluation in our study was as follows: (1) We used abdominal computed tomography to explore the changes in abdominal blood vessels. (2)We compared the effects of peritoneal dialysis using blood glucose, HbAlC, albumin, urea nitrogen, creatinine, white blood cells, hs-CRP; peritoneal Kt/V of peritoneal function, and eGFR. (3) We compared the cytokines’ concentrations in the two groups while controlling for the other cytokines. Results and Discussion: (1) There was no significant difference in the abdominal blood vessels of the experimental group relative to the control group according to abdominal CT over the 6 months. (2) Our study demonstrates statistically significant effects of FIR therapy on the following parameters: creatinine (p = 0.039 *) and hs-CRP (p < 0.001 **) levels decreased significantly, and eGFR (p = 0.043 *), glucose (p < 0.001 **), and albumin (p = 0.048 *) levels increased significantly. Our study found that in the experimental group, creatinine and hs-CRP levels decreased significantly due to FIR therapy for 6 months. However, our study also found that the glucose level was significantly different

after FIR therapy for 6 months. Peritoneal dialysis combined with FIR can reduce the side effects of the glucose in the dialysis buffer, which interferes with peritoneal inflammation and peritoneal mesothelial cell fibrosis. (3) In addition, we also found that no statistically significant difference in any inflammatory cytokine after FIR therapy. IFN- (p = 0.124), IL-12p70 (p = 0.093), IL-18 (p = 0.213), and TNF- (p = 0.254) did not exhibit significant improvements after peritoneal dialysis with FIR treatment over 6 months. Conclusions: We found that the effectiveness of peritoneal dialysis was improved significantly with FIR therapy, and significant improvements in the peritoneal permeability and inflammatory response were observed.

-J Clin Med. 2022 Mar 15;11(6):1624.

The Effect of Far-Infrared Therapy on the Peritoneal Membrane Transport Characteristics of Uremic Patients Undergoing Peritoneal Dialysis: An Open-Prospective Proof-of-Concept Study

Fri, 08 Oct 2021 12:38:33 GMT

Abstract

Long-term peritoneal dialysis (PD) can lead to detrimental changes in peritoneal membrane function, which may be related to the accumulation of glucose degradation products. A previous study demonstrated that 6 months of far-infrared (FIR) therapy may decrease glucose degradation products in PD dialysate. Due to limited literature on this matter, this study aims to investigate the effect of FIR therapy on the peritoneal membrane transport characteristics of PD patients. Patients were grouped according to baseline peritoneal transport status: lower transporters (low and low-average) and higher transporters (high-average and high). Both groups underwent 40 min of FIR therapy twice daily for 1 year. In lower transporters, FIR therapy increased weekly dialysate creatinine clearance (6.91 L/wk/1.73 m2; p = 0.04) and D/P creatinine (0.05; p = 0.01). In higher transporters, FIR therapy decreased D/P creatinine (−0.05; p = 0.01) and increased D/D0 glucose (0.05; p = 0.006). Fifty percent of high transporter patients shifted to high-average status after FIR therapy. FIR therapy may decrease D/P creatinine for patients in the higher transporter group and cause high transporters to shift to high-average status, which suggests the potential of FIR therapy in improving peritoneal membrane function in PD patients.

-Membranes (Basel). 2021 Aug 30;11(9):669.

The Effect of Far-Infrared Therapy on the Peritoneal Expression of Glucose Degradation Products in Diabetic Patients on Peritoneal Dialysis

Thu, 01 Jul 2021 12:27:26 GMT

Abstract

Peritoneal dialysis (PD) is a treatment modality for end-stage renal disease (ESRD) patients. Dextrose is a common osmotic agent used in PD solutions and its absorption may exacerbate diabetes mellitus, a common complication of ESRD. PD solutions also contain glucose degradation products (GDPs) that may lead to encapsulating peritoneal sclerosis (EPS), a severe complication of PD. A previous study showed that far-infrared (FIR) therapy improved a patient’s gastrointestinal symptoms due to EPS. Due to limited literature on the matter, this study aims to investigate dialysate GDPs and peritoneal function in diabetic patients on PD. Thirty-one PD patients were enrolled and underwent 40 min of FIR therapy twice daily for six months. We demonstrated the effect of FIR therapy on the following: (1) decrease of methylglyoxal (p = 0.02), furfural (p = 0.005), and 5-hydroxymethylfurfural (p = 0.03), (2) increase of D/D0 glucose ratio (p = 0.03), and (3) decrease of potassium levels (p = 0.008) in both DM and non-DM patients, as well as (4) maintenance and increase of peritoneal Kt/V in DM and non-DM patients, respectively (p = 0.03). FIR therapy is a non-invasive intervention that can decrease dialysate GDPs in PD patients by improving peritoneal transport rate and solute removal clearance, while also maintaining dialysis adequacy.

-Int J Mol Sci. 2021 Apr 2;22(7):3732.

Double-Pokemon-Ball Sign in Encapsulating Peritoneal Sclerosis Responsive to Far-Infrared Therapy

Sun, 27 Jun 2021 12:50:15 GMT

Abstract

Encapsulating Peritoneal Sclerosis (EPS) is a rare but serious complication of peritoneal dialysis. Medical treatment for EPS includes a combination of anti-fibrotic and anti-inflammatory agents. Despite optimal treatment, EPS is still associated with a high risk of morbidity and mortality. We present a case of EPS who was successfully treated with tamoxifen and far-infrared therapy. The abdominal computed tomography scan mimicked the “double-Pokemon-ball sign”.

-Clin Surg. 2020;5(1):3009.

Far Infrared Therapy for Arterio Venous Fistula

Sat, 28 Nov 2020 08:46:48 GMT

Introduction

Chronic HD patients, 81% with AVF and 19% via CVC (according to March 2016 CUH total CVCs).

Optimum management of vascular access is vital for the survival of HD patients. It is vital that these AVFs are matured, well maintained and continue to function efficiently throughout a patient’s time on HD.

Complications of AVF

Infections
Stenosis
Thrombosis
Steal Syndromes
Bruises and infiltration
Prolonged waiting time of AVF cannulation
Failed AVF-post operation
Painful AVF from cannulations
Reduced access flow

Apart from infections, stenosis, steal syndromes and thrombosis, the common complications of AVF includes bruises and infiltrations related to failed cannulation, prolonged waiting time of cannulation due to underdeveloped AVF, failed AVF due to poor surgical technique during operations. Many patients also report pain of the AVF access site during cannulation. Reduced access flow – due to calcified arteries/veins leading to thrombosis. There are limited treatment options for patients presenting with these problems.

Protocol

A protocol has been developed by the renal team at CUH based on the recommendations from the Renal Association standard Guidelines in the UK, Vascular Access Guidelines under 6.2.

Selection and recommendation

Post AVF creation
Steal Syndrome
Low access flow
AVF bruises due to infiltration from previous cannulation
Painful AVF cannulation site

Exclusions

Partially clotted AVF – confirm clots via ultrasound and aspiration of clots during cannulation

Skin infections

Pilot study

Case study: AVF maturation period using FIR Therapy

5 patients were recruited: 1 control patient

Criteria

Haemodialysis using CVC as access for HD
First AVF creation: radio-cephalic AVF
Age group: 18 to 60
Non diabetic

Methodology/Measurement

Done by a vascular access link nurse

Ultrasound measurement using the standard sonosite machine

Protocol: Measure the size of the veins (both arterial and venous access site) arterial access site: 5 cm after the anastomosis and venous access site measured 10 cm away from the arterial access site. Measurement done in every dialysis session.

Result (On-going study)

Conclusion

We have found FIR therapy is beneficial for the maturation of AVFs, particularly in patients with challenging access.

FIR is a safe and effective treatment of problems such as AVF bruises and haematoma (through its direct anti-inflammatory properties).

Author's:

Regin Lagaac

Site:

Cambridge University Hospitals

Presented at the 2019 VASBI Conference.

The effectiveness of far-infrared irradiation on foot skin surface temperature and heart rate variability in healthy adults over 50 years of age - A randomized study

Sat, 14 Nov 2020 09:50:20 GMT

Abstract

Background

Far-infrared irradiation (FIR) is used in the medical field to improve wound healing, hemodialysis with peripheral artery

occlusive disease, and osteoarthritis but seldom used in ameliorating poor lower extremity circulation. The purpose of this study was

to evaluate the effect of FIR on changes in foot skin surface temperature (FSST) and autonomic nerve system (ANS) activity to

evaluate its effectiveness in improving lower limb circulation.

Methods

A randomized controlled study was conducted. Subjects (n=44), all over the age of 50 years and satisfying the inclusion

criteria, were randomly allocated into 2 groups. The intervention group received FIR on a lower limb for 40minutes and the control

group received no intervention. Left big toe (LBT), right big toe (RBT), left foot dorsal (LFD), right foot dorsal (RFD) surface skin

temperature, autonomic nervous activity, and blood pressure were assessed.

Result

The main results were skin surface temperature at the LBT increased from 30.8±0.4°C to 34.8±0.4°C, at RBT increased

from 29.6±0.4°C to 35.3±0.4°C and LFD increased from 31.9±0.3°C to 36.4±0.4°C, RFD increased from 30.7±0.3°C to 37.7±

0.2°C. FIR caused a significant increase of the FSST ranging in a 4°C to 7°C increase after 40minutes irradiation (P<.001). The ANS

low-frequency (LF) and high-frequency (HF) activity showed a statistically significant increase in the FIR group (P<.05) but not the LF/

HF ratio.

Conclusion

FIR significantly increased the FSST from between 4°C and 7°C after 40minutes irradiation, which might improve

lower extremity circulation and regulation of ANS activity.

-Medicine (Baltimore). 2020 Dec 11;99(50):e23366.

Effects of Far-Infrared Therapy on Foot Circulation Among Hemodialysis Patients With Diabetes Mellitus

Fri, 02 Oct 2020 12:28:11 GMT

Abstract

Background

Far-infrared radiation (FIR) therapy improves vessel dilation, circulation, vessel endothelial function, and angiogenesis and reduces atherosclerosis. However, evidence of FIR therapy’s effects on foot circulation among diabetic patients undergoing hemodialysis is scarce.

Aim

To determine whether FIR therapy improves foot circulation in diabetic patients undergoing hemodialysis. Design: Quasi-experimental.

Methods

In June to November 2017, diabetic patients undergoing hemodialysis (N=58) at a hemodialysis center in northern Taiwan were divided into two groups: the experimental group (n=31) received FIR therapy to the bilateral dorsalis pedis artery (40 min/session, 3 times/week for 6 months) and the control group (n=27) received conventional dialysis care. Paired t test, independent samples t test, two proportion Z test, and repeated-measures analysis of covariance were performed to compare changes from baseline to the end of the 6-month intervention between the groups.

Results

Significant positive effects of FIR therapy on temperature, pulse, and blood flow of the dorsalis pedis artery were observed. Sensitivity to pain, tactility, and pressure also improved significantly in the experimental group. The Edinburgh Claudication Questionnaire revealed that the experimental group had reductions in subjective experiences of soreness, tingling, and coldness in the feet.

Conclusions

The findings of significant improvements to objective and subjective measures of blood flow and neural function in the experimental group indicate that FIR therapy improves blood circulation to the feet. This therapy thus has great potential to be an effective adjuvant treatment for patients with diabetes mellitus undergoing hemodialysis.

-Biol Res Nurs. 2020 Jul;22(3): 403-411

Far-infrared radiation prevents decline in β-cell mass and function in diabetic mice via the mitochondria-mediated Sirtuin1 pathway

Sat, 26 Sep 2020 14:00:10 GMT

Abstract

Insulin deficiency in type 2 diabetesmellitus (DM) involves a decline in both pancreatic β-cellmass and function. Enhancing β-cell preservation represents an important therapeutic strategy to treat type 2 DM. Far-infrared (FIR) radiation has been found to induce promyelocytic leukemia zinc finger protein (PLZF) activation to protect the vascular endothelium in diabetic mice. The influence of FIR on β-cell preservation is unknown. Our previous study reveals that the biologically effective wavelength of FIR is 8–10 μm. In the present study, we investigated the biological effects of FIR (8–10 μm) on both survival and insulin secretion function of β-cells. FIR reduced pancreatic islets loss and increased insulin secretion in nicotinamide-streptozotocin-inducedDMmice, but only promoted insulin secretion in DM PLZF−/− mice. FIR-upregulated PLZF to induce an anti-apoptotic effect in a β cell line RIN-m5f. FIR also upregulated mitochondrial function and the ratio of NAD+/NADH, and then induced Sirtuin1 (Sirt1) expression. The mitochondria Complex I inhibitor rotenone blocked FIR-induced PLZF and Sirt1. The Sirt1 inhibitor EX527 and Sirt1 siRNA inhibited FIR-induced PLZF and insulin respectively. Sirt1 upregulation also increased CaV1.2 expression and calcium influx that promotes insulin secretion in β-cells. In summary, FIR-enhanced mitochondrial function prevents β-cell apoptosis and enhances insulin secretion in DM mice through the Sirt1 pathway.

- Metabolism Clinical and Experimental 104 (2020) 154143

Far infrared therapy for arteriovenous fistulas

Tue, 04 Aug 2020 14:15:54 GMT

Reliable, safe and effective vascular access is the Achilles’ heel of haemodialysis (HD). It is widely accepted that a functioning arteriovenous fistula (AVF) is the best form of access for HD; this is reflected in the fact that there will be a future target of 85% for the number of prevalent patients dialysis via an AVF in UK HD units. When compared with AV grafts and dialysis catheters, AVFs are associated with a lower infection rate and, therefore, reduced patient morbidity, mortality and length of stay in hospital. Dialysis adequacy is also superior via and AVF, leading to improved patient well-being and quality of life. For these reasons, it is highly desirable that a patient already has a functioning AVF established when they start HD. Equally, it is vital that these AVFs are well maintained and continue to function efficiently throughout a patient’s time on HD.

A common reason for failure of an AVF is thrombosis. Reduced blood flow through an AVF increases the risk of thrombosis and this is often caused by AVF stenosis, usually at the level of the venous outflow. Adequate blood flow through an AVF is also necessary to achieve sufficient clearance of small solutes, with a blood flow of 250-500ml/min being desirable. Improved blood flow through AVFs and a reduction in the rate of AVF stenosis will, therefore, improve dialysis adequacy and enhance patient outcomes. Novel treatment strategies to achieve these goals are being explored.

Far infrared therapy (FIRAPY)

Infrared is invisible electromagnetic radiation with a wavelength that is longer than visible light. It can be subdivided according to wavelength into near infrared (0.8-1.5μm), middle infrared (1.5-5.6μm) and far infrared (5.6-1,000μm). There is increasing evidence that infrared radiation has beneficial effect on tissue healing and endothelial function, which has led to its use in the treatment of skin necrosis and wound healing. The application of far infrared therapy (FIR) to AVFs in HD patients has been studied as a way to improve fistula blood flow, thereby reducing complications of fistula thrombosis and improving dialysis adequacy.

FIR is a safe treatment. A40-minute sessions is associated with a rise in skin temperature to 38-39℃, without causing the skin irritation of burin injury sometimes associated with other types of thermal therapy

FIR appears to benefit AVF function through both thermal and non-thermal effect. Infrared radiation is sensed as heat by thermos-receptors, with an increase in temperature of up to 4℃ at a depth of 10mm when applied to skin. This has a vasodilatation effect, which improves blood flow through the fistula.

The non-thermal effects of FIR on AVF function are achieved via its effect on the vascular endothelium. FIR increase heme oxygenase-1 (HO-1), an enzyme and an important regulator of endothelial inflammation. HO-1 induction reduces platelet aggregation and vascular smooth muscle growth, creating a less thrombogenic surface within blood vessels. FIR, therefore, reduces vascular inflammation through HO-1 induction. It does so in a time-dependent fashion, such that the greater the length of FIR exposure, the greater the amount of HO-1 induction. A randomized controlled trial by Lin et al demonstrated improved blood flow rates and a reduction in AVF malfunction in HD patients treated with FIR. They hypothesized that the benefit were due to the anti-inflammatory properties of FIR.

The Sunderland experience

FIR for AVFs was introduced to our renal unit in December 2008. Initially, it was used to help maintain AVF function by treating haematomas and pain on needling. We found FIR an effective treatment in this clinical setting and have presented data on this area at international nephrology meetings.

FIR has now been adopted into a systematic programme of treatment for our predialysis and HD populations at City Hospitals Sunderland NHS Foundations Trust (CHSFT). Patients are treated immediately after AVF formation with three FIR sessions per week. FIR continues for an average of six weeks. Doppler ultrasound is used to measure AVF flow rate and an assessment from the multidisciplinary team determines if the AVF has matured sufficiently to enable efficient HD, or if further surgical or radiological intervention on the AVF is thought necessary. Figure1 outline the protocol at CHSFT for the application of FIR to new AVFs.

Figure 1. AVF maturation and thrombosis treatment pathway. An algorithm for the use of FIR therapy in the maturation of a new AVF or the resolution of thrombosis or haematoma in an existing AVF

Author's: Timothy Shipley, Debbie Sweeney, Iain Moore, Sean Fenwick, Hatem Mansy, Saeed Ahmed

Site: City Hospital Sunderland NHS Foundation Trust

The original posted in British Journal of Renal Medicine 2013; Vol 18 No 4, P30-31

FIR can be continued for a longer period of time if future development of the AVF is thought to be feasible. It is an extremely well-tolerated treatment, with no side-effects reported by any of the patients undergoing the treatment at CHSFT.

Between January 2011 and April 2012, 1,272 individual FIR sessions took place at CHSFT on 139 patients – 903 for HD patients and 369 for predialysis patients. The average number of treatment sessions per patient was just under ten. Patients attended the renal outpatient department at the hospital three times a week for their treatment, which takes place in a dedicated room next door to the HD unit under the management and supervision of a team of specialist renal nurses.

The flexibility of the treatment allows in-centre treatment during dialysis, clinic visits or inpatient admission, or treatment at home using a portable device (see Figure 2).

Figure 2. A portable far infrared therapy machine being used to treat a patient with a patient with a new arteriovenous fistula

Patients have objectively recorded a reduced pain score on needling an AVF under the influence of FIR, as well as improvement in haematoma resolution. We surveyed 40 patients on our HD unit who underwent FIR of their AVF because of pain associated with needling (see Figure 3). Patient testimonials have been integral to developing our service further.

Figure 3. Reduction in pain score during fistula needling under the influence of infrared therapy

Conclusion

The creation and preservation of AVF is vital to ensure the best possible outcomes for HD patients. However, the high rate of complications associated with this process pose a significant challenge. FIR is a safe and effective treatment modality that has been shown to reduce these complications and improve the efficiency of AVFs through its direct anti-inflammatory properties.

At CHSFT, we have shown that it is possible to set up a dedicated, nurse-led FIR service within a busy dialysis unit, which is available to all patients with CKKD who have AVFs. Our experience and feedback from patients informs us that it is a well-tolerated treatment that reduces pain for patients during needling, and has the potential to improve patient outcomes by optimizing their HD treatment through better vascular access.

Far Infrared Therapy May Improve Arterial Insufficiency and Joint Inflammation in CKD Stage 5 Patients

Wed, 12 Feb 2020 03:20:11 GMT

Introduction

Far infrared (FIR) induces expression of endothelial heme oxygenase-1, reduces monocyte adhesion to endothelial cells, and provides a strong anti-inflammatory benefit to the vascular endothelium. It has been shown that FIR therapy improves to the vascular endothelium. It has been shown that FIR therapy improves dialysis fistula flow, maturation, and patency and leads to decrease pain and hematoma formation with needling in CKD stage 5 and 5d patients. It is also effective in relieving pain in patients with chronic pain syndromes like fibromyalgia and phantom limb after amputation through thermal and non-thermal effects. In the past we reported an improvement in graft stenosis and resolution of internal jugular vein thrombus associated with tunneled catheter insertion in two dialysis patients with FIR therapy. Now we report 3 CKD stage 5 patients with improvement of arterial insufficiency, frozen shoulder and partial rotator cuff injury using FIR therapy.

Case description

Case 1

A 68 year old man with CKD 5 due to FSGS and HTN developed significant claudication on his right leg and discoloration of his second toe. An arteriogram showed substantial small arterial disease not amenable to bypass and below knee amputation was recommended by his surgeon. A trial of FIR therapy on his leg was done, and after three weeks, claudication and toe discoloration resolved. FIR therapy was stopped and he remained pain free after 2 years of follow-up.

Case 2

A 67 year old man with CKD 5d due to HTN developed left shoulder pain with restricted range of motion. Analgesics and 3 weeks of physical therapy (PT) did not provide relief. A trial of 40 minutes of FIR therapy 3 times a week during dialysis was done. After 3 weeks, his frozen shoulder improved completely.

Case 3

A 75 year old woman with CKD 5 developed right partial rotator cuff tear after a fall. Diagnosis was confirmed by MRI and surgery was recommended. She refused surgery and tried 2 months of PT, which did not provide relief. Trial of FIR therapy was done with compete resolution of pain and stiffness after 3 weeks.

Discussion

FIR therapy may have beneficial effect on arterial insufficiency and joint injury and inflammation and should be considered in CKD 5 patients suffering from these conditions. It is non-invasive and can be easily done as 40-minute sessions in the clinic or during dialysis treatments

a Independent t test; b Chi-square test; c Fisher's exact test; d Mann-Whitney test

Author's:

S Akbar,
C Irene Mejia
R Ullah
S Humaria
Z Ahmed
R Faruq
H Arif

Site:

Nephrology and Hypertension, Drexel University College of Medicine, Philadelphia
Drexel University College of Medicine, Philadelphia
Drexel University, Philadelphia

Presented at the 2019 ASN Conference.

Far‑infrared therapy improves ankle brachial index in hemodialysis patients with peripheral artery disease

Sat, 26 Oct 2019 12:09:44 GMT

Abstract

Ankle brachial index (ABI) is a diagnostic tool for peripheral artery disease (PAD), which is an important issue in hemodialysis

(HD) patients. We enrolled 198 maintenance HD patients in this study. PAD is defined as ABI ≤ 0.90. Only PAD

patients received far-infrared (FIR) therapy using the WS TY101 FIR emitter for 40 min during each HD session, three

times weekly for 6 months. The ABI was measured at the bilateral lower extremities for 4 times [pre-dialytic timing (0 min)

and 40 min after the initiation of HD session at both day 0 and 6 months after the FIR therapy]. The primary outcome

is the change in ABI. There were 51 out of 198 patients with PAD. In comparison with the period without FIR therapy

in the 51 PAD patients, 6 months of FIR therapy significantly improved the ABI of the right/left side for 0 min (from

0.77 ± 0.19 to 0.81 ± 0.20, p = 0.027/0.79 ± 0.20 to 0.81 ± 0.17, p = 0.049), 40 min during HD (from 0.73 ± 0.23 to 0.83 ± 0.19,

p < 0.001/from 0.77 ± 0.21 to 0.83 ± 0.18, p < 0.001), and the incremental change between 0 and 40 min (from − 0.04 ± 0.14

to 0.05 ± 0.13, p = 0.007/from − 0.05 ± 0.13 to 0.03 ± 0.11, p = 0.012), respectively. In conclusion, the application of FIR

therapy for 40 min, three times weekly for 6 months, has improved the ABI of both lower extremities, thus providing a new

strategy of PAD treatment in HD patients.

-Heart Vessels (2019) 34: 435-441

Far Infrared Therapy - a novel treatment for AV Fistula Maturation and Maintenance

Thu, 10 Oct 2019 04:15:17 GMT

In Addenbrookes Renal Dialysis Unit, since January 2015, we have been using FIR therapy. We have demonstrated FIR therapy to help improve arterio-venous fistula (AVF) prevalence, maturation and patency, as well as blood flow rates, pain on needling and haematoma size post-needle tissue in our haemodialysis (HD).

FIR therapy is a non-invasive treatment of 40 minutes duration. It induces expression of endothelial Heme Oxygenase-1, reducing monocyte adhesions in endothelium cells and impending inflammatory responses. The theory is that this reduces further endothelial injury and dysfunction.

Tariff and efficiency

UK Renal units and renal commissioners are now focused on achieving > 80% incident and prevalent permanent vascular access rates. The tariff Renal units receive for HD has been revised and is now inextricably linked to the type of vascular access used.

This provides further economic incentive to improve AVF rates in incident and prevalent HD patients.

Inclusions

New patients that have just undergone AVF creation
AVF bruises due to infiltration from previous cannulation
Painful arteriovenous fistula (pain situated in the area of cannulation)

Our experience

40 patients benefited from the use of the FIR therapy

15 patients had an improvement of pain score on needling of AVF

14 patients AVF needle-site haematomas resolved quicker

11 AVFs matured with demonstrably better blood flow rates on Doppler in patients with previous AVF maturation failure

It is cost effective as we are not useing heparinoid cream to relieve bruising of the AVF, post infiltration.

Conclusions

We have found FIR therapy to be of use in the maturation of AVFs, particularly in patients with challenging access, as well as in the treatment of problems such as haematoma formation and those experiencing AVF pain during HD.

Author's:

Regin Lagaac

Site:

Cambridge University Hospitals

Presented at the 2018 UKKW Conference.

Far-infrared therapy for secondary vascular access patency of hemodialysis patients

Tue, 01 Oct 2019 12:42:39 GMT

Abstract

Introduction: Far-infrared radiation therapy (FIRT), which utilizes an invisible electromagnetic wave, has demonstrated its ability to improve vascular access flow for hemodialysis (HD) patients. Although previous overseas studies revealed the beneficial effects of FIRT on HD patients by improving vascular function, no study in Japan has examined the clinical efficacy of FIRT for such patients. Therefore, we aimed to evaluate the usefulness of FIRT for HD patients. We paid particular attention on secondary vascular access (VA) patency of HD patients.

Methods: Eighteen patients who had undergone vasodilation of VA vessels or vascularization more than once were selected from approximately 70 outpatients receiving HD in the Dialysis Unit of the Juntendo University Hospital. FIRT was administered for 40 min during HD three times per week for 1 year to the not frequent VA treatment (nf-VAT) group, for which VA intervention had been performed no more than two times during the 1 year, and to the frequent VA treatment (f-VAT) group, for which VA intervention had been performed three times or more over the 1 year. Variables including VA treatment interval were compared between those groups.

Results: The nf-VAT group did not require VA re-treatment during the study period. The VA treatment interval was significantly prolonged in the f-VAT group. The fistula diameter expanded, and intimal thickening improved significantly in the nf-VAT group. Oxidized low-density lipoprotein cholesterol levels decreased slightly.

Conclusion: This study suggested that FIRT is effective for improving secondary VA patency.

-Io et al. Renal Replacement Therapy (2019) 5:31

Effects of Far Infrared Therapy on Vascular Access Blood Flow and Needling Pain in Hemodialysis Patients

Fri, 26 Jul 2019 08:36:33 GMT

Introduction

A well-functioning vascular access and minimal needling pain is essential for achieving uneventful hemodialysis (HD) and improving quality of life in patients treated with long term hemodialysis1. Far

infrared (FIR) therapy, a convenient and non-invasive technology reported improves access blood flow with reduction of vascular access malfunction in hemodialysis patients. The aim of this

study was to evaluate the effects of FIR therapy on vascular access flow and needling pain in HD patients.

Methodology

This was a multicenter, randomized controlled trial over a period of 2 months. Eligible patients were patients more than 18 years who used native fistula with the vascular access flow rate of 400-800 ml/min. Patients who used arteriovenous graft, had deepseated arteriovenous fistula with the

depth more than 6mm, having heart failure with NYHA class III and IV, had two or more percutaneous transluminal angioplasties, had a recent cardiovascular or cerebrovascular

event within 3 months prior to the study are excluded. All enrolled patients were maintained with 4 hours of dialysis 3 times/week. FIR therapy using FIRAPY (Far-infared Therapy Unit) model TY-

102F was performed 40 minutes during each HD session. Vascular access flow measured at baseline, 30 and 60 days after therapy. Needling pain was measured with a numeric rating scale

at baseline and 30 days after.

Result

Table 1: Socio-demographic and clinical characteristics

a Independent t test; b Chi-square test; c Fisher's exact test; d Mann-Whitney test

Conclusion

FIR therapy improved needling pain. Although FIR therapy improved vascular access flow after 2 months but statistically it is not significant. A larger and longer duration of study is

needed to evaluate the effect of FIR therapy.

Author's:

S Fatimah Khalid,
WM Zulhilmi W Ibrahim, Hazwani A Ghani,
Lily Mushahar

Site:

Nephrology Department, Hospital Tuanku Jaafar
Hospital Jelebu
Hospital Tampin

Presented at the 2019 APSDA Conference.

FIRAPY reduce the need & frequency of Fistuloplasty

Tue, 01 May 2018 07:03:28 GMT

FIRAPY is a physical treatment utilizing infrared radiation with longer wavelengths than visible light. This energy, has applications in health promotion and wound healing. FIRAPY is delivered via a device with ceramic plates, placed above an arteriovenous fistula (AVF) during hemodialysis sessions. Studies suggest that FIR enhances blood flow and patency in AVFs, reduces pain from steal syndrome, and inhibits endothelial inflammation, addressing key factors in AVF stenosis and thrombosis.

A study at Raigmore Hospital, Inverness, highlighted FIRAPY's impact on reducing fistuloplasty frequency. Comparing data from 2011-2013 to 2014-2016, after FIRAPY was introduced, showed a 21% reduction in procedures. Individual cases demonstrated extended intervals between fistuloplasties following FIR initiation. Despite barriers like cost, staff training, and patient refusal, FIRAPY therapy proved effective, convenient, and cost-saving, reducing hospital stays for hemodialysis patients with AVF complications.

Patient Selection

Poor maturation of AVF
After first or requiring regular fistuloplasty
Steal Syndrome
Patients referred from weekly vascular MDT

Application of FIRAPY

To be used on native AV fistulae only
Fistula limb must be uncovered
Applied during every dialysis session, 40 min duration

Result

Conclusion

FIRAPY used on a regular basis does reduce the need for interventions.
It is an easy and convenient mode of therapy.
Cost effective.
Leads to a reduction in in-patients stays for HD patients due to fistula complication.

Arthur: Dr Susan Stewart

Site: Raigmore Hospital, Inverness, UK

Presented at the 2017 BRS Conference.

A single treatment, using Far Infrared light improves blood flow conditions in arteriovenous fistula

Wed, 01 Nov 2017 13:08:00 GMT

Abstract

BACKGROUND: A native arteriovenous fistula (AVF) is recommended for angio access in patients on chronic hemodialysis

(HD). Fistula patency has been improved by exposure to Far Infrared light (FIR).

OBJECTIVE: To investigate whether a single FIR treatment could alter blood velocity, AVF diameter or inflammatory

markers.

METHODS: Thirty patients with a nativeAVF in the forearm were included. Each patientwas his/her own control. Ultrasound

(US) examinations were performed before and after a single FIR treatment.

RESULTS: A single FIR treatment resulted in a significant increase in blood velocity over the AV fistula from a mean of

2.1 ± 1.0 m/s to 2.3 ± 1.0 m/s (p = 0.02). The diameter of the arterialized vein became wider; 0,72 cm ± 0.02 to 0,80 cm ± 0.02,

(p = 0.006). The increase in fistula blood velocity correlated positively with base line serum- urate p = 0.004) and the increase

in venous diameter with the base line plasma orosomucoid concentration (p = 0.005).

CONCLUSIONS: This study shows that a single FIR treatment significantly increasedAVF blood velocity and vein diameter.

Thus, one FIR treatment can help maturation of AVF in the early postoperative course.

-Clinical Hemorheology and Microcirculation 66 (2017) 211–217

Treatment of Thromboangiitis Obliterans Using Smoking Cessation and Far-infrared Therapy: A Case Study

Thu, 05 Oct 2017 09:39:29 GMT

Abstract

Thromboangiitis obliterans (Buerger’s disease) is a rare, nonatherosclerotic segmental inflammatory vasculitis that commonly involves small- and medium-sized vessels. Ischemic tenderness impairs patient quality of life and places patients at high risk for amputation. The only definitive known treatment is smoking cessation. Far-infrared (FIR) therapy has shown promising effects on blood flow and healing, but its use in patients with Buerger’s disease has not been reported.

A 31-year-old man with a 15-pack-year history of smoking, no drug abuse, and no other significant medical history, trauma, or family history diagnosed with thromboangiitis obliterans presented for care at the authors’ clinic. Claudication with severe tenderness of both legs and an ischemic ulcer over the right big toe were noted. After surgical debridement of the devitalized tissue, the patient received FIR therapy (5–25 μm, peak at 8.2 μm) applied 25 cm above the surface of the ischemic wound for 40 minutes, 3 times per week. The patient also tapered his smoking. The wound started to heal; granulation tissue was evident and, after 8 weeks, the right lower extremities gradually rewarmed from 24˚ C to 28˚ C as measured on the dorsal foot. His pain level decreased from 8 to 5. FIR therapy was continued until the patient stopped smoking (8 months). At the 10-month follow-up visit, the wound had healed completely and resting pain had improved. The results of this case study suggest additional research to explore the potential effects of FIR on patients with thromboangiitis obliterans is warranted.

Thromboangiitis obliterans (TAO), also known as Buerger’s disease, is a nonatherosclerotic segmental inflammatory disease of the small- and medium-sized arteries and veins of the extremities. It typically occurs in young males and smokers, with onset of symptoms before the age of 40 to 45 years. The prevalence of this disease varies widely, ranging from as low as 0.5% to 5.6% in Western Europe to as high as 45% to 63% in India and 16% to 66% in Korea and Japan. TAO may present initially as episodic pain and coldness in the extremity. As the disease progresses, intermittent claudication, pain at rest, ischemic ulcerations, and gangrene of the critical limb can develop, which can lead to eventual amputation.

Smoking cessation is the only known definitive therapy for the management of TAO. The effectiveness of other treatments including vasodilation or anti-clotting drugs, surgical revascularization, or sympathectomy in preventing amputation or treating pain remains to be determined.

Far-infrared (FIR) therapy is an invisible electromagnetic wave with a longer wave length (3 to 1000 μm) than that of visible light. In a systemic review by Bashar et al which included 4 randomized, controlled trials (666 patients), FIR therapy improved endothelial function and hemodynamics in coronary arteries by upregulating endothelial nitric oxide synthase expression in the arterial endothelium, stimulating secretion of transforming growth factor-beta (TGF-beta) and activation of fibroblasts to improve wound healing independent of skin blood flow and skin temperature and improving the patency of arteriovenous fistula. In a randomized, controlled study by Lin et al (122 patients), FIR therapy improved the access flow, maturation, and patency of arteriovenous fistulae as measured by Doppler

ultrasonography. In an animal study, FIR therapy promoted angiogenesis in ischemia-induced diabetic mice by enhancing endothelial progenitor cell function and the homing process. In the clinical evaluation and laboratory study by Li et al, a total of 32 patients affected by stage II and stage III lymphedema were treated with FIR therapy. A significant decrease in limb circumference was noted; microcirculation flow was promoted and collateral lymph circumfluence was improved without significant adverse events. Nevertheless, no report has been published about the use of adjunctive FIR therapy in a wound caused by TAO. This is a report of a patient with TAO with an ischemic ulcer over his right big toe and claudication of both legs successfully treated with smoking cessation and FIR therapy.

-Ostomy Wound Manage 2017 Jul;63(7):20-23.

Association of Far-Infrared Radiation Therapy and Ankle-Brachial Index of Patients on Hemodialysis with Peripheral Artery Occlusive Disease

Sun, 13 Aug 2017 12:17:16 GMT

Abstract

Background and Aim

The ankle-brachial index (ABI) is recognized to be a good marker for

atherosclerosis, and is useful in the diagnosis of peripheral artery occlusive disease (PAOD) which

is prevalent among patients on hemodialysis (HD).

Methods

This randomized trial aimed to evaluate the effect of far-infrared radiation (FIR) therapy on ABI in HD patients with PAOD. PAOD was defined as patients with ABI < 0.95. One hundred and eight HD patients were enrolled, including 50 in the control group and 58 in the FIR group. A WS TY101 FIR emitter was applied for 40 minutes during each HD session, three times per week for six months. The ABI was measured before and after the FIR therapy.

Results

Regardless of FIR therapy, the bilateral ABI decreased (in the FIR group, left: 0.88±0.22 to 0.85±0.24, p = 0.188; right: 0.92±0.20 to 0.90±0.23, p = 0.372; in control group, left: 0.91±0.23 to 0.88±0.21, p = 0144; right: 0.93±0.17 to 0.89±0.21, p = 0.082). Multivariate logistic analysis of the FIR group revealed that high uric acid (odds ratio [OR]: 2.335; 95% confidence interval [CI]: 1.117-4.882; p=0.024) and aspirin use (OR: 16.463; 95% CI: 1.787-151.638; p=0.013) were independently associated with increased bilateral ABI after FIR therapy.

Conclusions

This study demonstrates that ABI is not increased after FIR therapy in HD patients with PAOD. However, in the FIR group, patients with higher uric acid level or those who used aspirin have increased bilateral ABI after FIR therapy.

-Int. J. Med. Sci. 2016, 13(12): 970-976

Oxygenation dynamics of sepsis patients undergoing far-infrared intervention based on near-infrared spectroscopy

Sat, 01 Jul 2017 10:30:19 GMT

Abstract

Near-infrared spectroscopy (NIRS; continuous wave type) is a noninvasive tool for detecting the relative change of oxyhemoglobin and deoxyhemoglobin. To make this change, intervention methods must be applied. This study determined the hemodynamics of 44 healthy participants and 35 patients with sepsis during exposure to FIR as a novel physical intervention approach. Local microcirculation of their brachioradialis was monitored during exposure and recovery through NIRS. The variations in blood flow and microvascular reaction were determined by conducting paired and unpaired t tests. The oxyhemoglobin levels of the healthy participants increased continuously, even during recovery. In contrast to expextations, the oxyhemoglobin levels of the patients plateaued after only 5 min of FIR illumination. The proposed method has potential applications for ensuring efficient treatment and facilitating doctors in diagnosing the functions of vessels in intensive care units. Mapping diagrams of HbO2 in healthy males and males with sepsis illustrated unique scenarios during the process.

-J Biophotonics. 2017 Mar;10(3):360-366.

Clinical utility of far-infrared therapy for improvement of vascular access blood flow and pain control in hemodialysis patients

Tue, 01 Nov 2016 04:10:34 GMT

Abstract

Background: Maintenance of a well-functioning vascular access and minimal needling pain are important goals for achieving adequate dialysis and improving the quality of life in hemodialysis (HD) patients. Far-infrared (FIR) therapy may improve endothelial function and increase access blood flow (Qa) and patency in HD patients. The aim of this study was to evaluate effects of FIR therapy on Qa and

patency, and needling pain in HD patients.

Methods: This prospective clinical trial enrolled 25 outpatients who maintained HD with arteriovenous fistula. The other 25 patients were matched as control with age, sex, and diabetes. FIR therapy was administered for 40 minutes during HD 3 times/wk and continued for 12 months. The Qa was measured by the ultrasound dilution method, whereas pain was measured by a numeric rating scale at baseline, then once per month.

Results: One patient was transferred to another facility, and 7 patients stopped FIR therapy because of an increased body temperature and discomfort. FIR therapy improved the needling pain score from 4 to 2 after 1 year. FIR therapy increased the Qa by 3 months and maintained this change until 1 year, whereas control patients showed the decrease in Qa. The 1-year unassisted patency with FIR therapy was not

significantly different from control.

Conclusion: FIR therapy improved needling pain. Although FIR therapy improved Qa, the unassisted patency was not different compared with the control. A larger and multicenter study is needed to evaluate the effect of FIR therapy.

-Kidney Res Clin Pract 35 (2016) 35e41

MicroRNA-134 Contributes to Glucose- Induced Endothelial Cell Dysfunction and This Effect Can Be Reversed by Far-Infrared Irradiation

Tue, 05 Apr 2016 12:34:43 GMT

Abstract

Diabetes mellitus (DM) is a metabolic disease that is increasing worldwide. Furthermore, it is associated with the deregulation of vascular-related functions, which can develop into major complications among DM patients. Endothelial colony forming cells (ECFCs) have the potential to bring about medical repairs because of their post-natal angiogenic activities; however, such activities are impaired by high glucose- (HG) and the DM-associated conditions. Far-infrared radiation (FIR) transfers energy as heat that is perceived by the thermoreceptors in human skin. Several studies have revealed that FIR improves vascular endothelial functioning and boost angiogenesis. FIR has been used as anti-inflammatory therapy and as a clinical treatment for peripheral circulation improvement. In addition to vascular repair, there is increasing evidence to show that FIR can be applied to a variety of diseases, including cardiovascular disorders, hypertension and arthritis. Yet mechanism of action of FIR and the biomarkers that indicate FIR effects remain unclear. MicroRNA-134 (miR-134-5p) was identified by small RNA sequencing as being increased in high glucose (HG) treated dfECFCs (HGdfECFCs). Highly expressed miR-134 was also validated in dmECFCs by RT-qPCR and it is associated with impaired angiogenic activities of ECFCs. The functioning of ECFCs is improved by FIR treatment and this occurs via a reduction in the level of miR-134 and an increase in the NRIP1 transcript, a direct target of miR-134. Using a mouse ischemic hindlimb model, the recovery of impaired blood flow in the presence of HG-dfECFCs was improved by FIR pretreatment and this enhanced functionality was decreased when there was miR-134 overexpression in the FIR pretreated HG-dfECFCs. In conclusion, our results reveal that the deregulation of miR-134 is involved in angiogenic defects found in DMpatients. FIR treatment improves the angiogenic activity of HG-dfECFCs and dmECFCs and FIR has potential as a treatment for DM. Detection of miR-134 expression in FIR-treated ECFCs should help us to

explore further the effectiveness of FIR therapy.

-PLoS One. 2016 Jan 22;11(1):e0147067

Gender-Related Effect in Oxygenation Dynamics by Using Far-Infrared Intervention with Near-Infrared Spectroscopy Measurement: A Gender Differences Controlled Trial

Tue, 01 Dec 2015 10:37:14 GMT

Abstract

Many studies have indicated the microcirculation can directly respond to disease-related symptoms. However, the capacity of microcirculation would vary due to the gender differences. Near-infrared spectroscopy (NIRS) is a noninvasive technique to monitor tissue oxygenation dynamics. In this study, the far-infrared (FIR) source was used for physiological intervention of microcirculation. The experimental results show that the nature difference of oxygenation status exists between male and female during FIR irradiation. Therefore, we suggest the NIRS-based assessment should be calibrated with the gender-related effect for clinical diagnosis of peripheral arterial disease.

-PLoS One. 2015 Nov 10;10(11)

Far Infrared Therapy as a Novel Treatment for Hand Ischemia Following Arteriovenous Graft for Hemodialysis

Tue, 01 Sep 2015 12:55:12 GMT

Abstract

Introduction: Hand ischemia following vascular access surgery is an uncommon complication. A clinical dilemma exists between prioritizing the preservation of vascular access and the need for surgical intervention to rescue the ischemic hand.

Report: An 80 year old man who had hand ischemia following creation of a polytetrafluoroethylene arteriovenous graft with clinical evidence of ischemic pain of the left hand and Doppler ultrasound evidence of diastolic flow reversal is described. Far infrared therapy (FIR) was applied over the distal part of the affected limb, and the symptoms and signs of ischemia improved remarkably. Follow up ultrasonography also revealed the disappearance of diastolic flow reversal.

Discussion: FIR therapy is a promising and non-invasive therapeutic modality to treat vascular access related

hand ischemia by decreasing vascular resistance and improving hand perfusion

-EJVES Short Reports (2015) 28, 30-33

Far-infrared Therapy as a Novel Treatment for Encapsulating Peritoneal Sclerosis

Wed, 01 Jul 2015 12:22:10 GMT

Letters to the Editor

......A 45-year-old man with a medical history of end-stage renal disease was admitted owing to abdominal fullness, vomiting, and poor appetite for 1 month. The patient had received 13 years of PD followed by removal of the PD catheter owing to refractory peritonitis, resulting in a shift to hemodialysis 2 months before this admission. A physical examination showed a body temperature of 36.5 °C, a

distended abdomen and hypoactive bowel sounds. Th e dialysate effluent was dark red in appearance. Laboratory examinations

revealed normal blood leukocyte count (WBC: 7,100/mm3 ) but an elevated C-reactive protein level (50.3 mg/l). An abdominal radiograph was obtained to evaluate his symptoms. The intestinal wall was outlined by continuous calcifications (Figure 1 , arrows), and the curvilinear calcification on the right side of the radiograph was peritoneal calcification (Figure 1, white arrows). A contrast enhanced

computed tomography scan demonstrated fluid within the abdomen surrounded by thickened, enhancing peritoneum. The adherent bowel loops were collected centrally by the encapsulating calcified peritoneum, supporting the diagnosis of EPS (Figure 2, white

arrows).

Aft er 3 months of far-infrared therapy, his bowel movement improved. He was able to tolerate a regular oral diet and the color of the dialysate effluent became lightly pink. Because of the improvement in the symptoms aft er far-infrared therapy, our patient decided to follow a conservative treatment plan. Follow-up contrast-enhanced computed tomography scan showed an improvement in dilated loops of small bowel (Figure 3, white arrows). Remarkably, his nutritional status also improved with a significant increase of serum albumin level from 2.7 to 4.2 g/dl, as well as body weight from 59.1 to 62.9 kg aft er far-infrared therapy for 12 months....

-Am J Gastroenterol. 2014 Dec;109(12):1957-9.

A single treatment, using Far Infrared light, increased bloodflow and AV-fistula diameter

Fri, 30 May 2014 07:45:47 GMT

Background and Aims

A native arterio-venous fistula (AVF) is considered the best alternative for access in patients on chronic hemodialysis(HD). However, its patency is often limited, because of complications, suchas stenosis, thrombosis and infection. Both surgical and medical methods have been evaluated to avoid often painful and costly interventions. In recent years a few studies from the same center have shown positive effects on blood flow and patency of repeated Far Infrared light(FIR) over the AVF.

The primary aim of this study was to evaluate if a single treatment, using FIR, may alter blood flow and AVF diameter.

The secondary aim of the study was to find if there were any changes in inflammatory markers.

Methods

Included were 30patients (17male and13 female) from a single center with a native AVF(end to side) located in the forearm, seetable1.

Ultrasound examination was performed by the same investigator in all patients over three measure points (artery, proximal and distal AVF), followed by one standard FIR treatment and thereafter a repeated examination.

Table 1. Demographic data

Result

Results: The AVF flow rate increased after one FIR treatment, mean 2.1±1 m/s to 2.3±1, (p=0.001).

There was a slight increase of the arterial and venous flow, however not significant. The diameter of the AVF and artery did not change while the vein became wider 0.72cm ±0.2 to 0.74 ±0.2 ( p=0.034), see table 2.

The change in AVF flow was not different in those with or without diabetes mellitus, hemodialysis,

prescribed statins, hypertensive treatment, anticoagulation or between men and women. The mean

arterial pressure, systolic and diastolic blood pressure did not change. The pulse decreased from a mean of 72 ±9.8 beats/min to 68 ±9.4, (p=0.043). There was no significant change in inflammatory

markers. All patients had a functioning AVF after 30 days.

Author's:

U. Hadimeri,
A. Wärme,
B. Stegmayr

Site:

Skaraborg Hospital, Skövde, SWEDEN,
Dept.of Nephrology, Skaraborg Hospital, Skövde, SWEDEN,
Public Health and Clinical Medicine, Umea University, Umea, SWEDEN

Presented at the 2014 ERA-EDTA Conference.

Post-angioplasty Far Infrared Radiation Therapy Improves 1-Year Angioplasty-Free Hemodialysis Access Patency of Recurrent Obstructive Lesions

Wed, 01 Jan 2014 12:48:35 GMT

Abstract

Objective: To explore the role of far infrared (FIR) radiation therapy for hemodialysis (HD) access maintenance after percutaneous transluminal angioplasties (PTA).

Methods: This was a prospective observational study. Eligible patients were those who received repeated PTA with the last PTA successfully performed within 1 week before the study enrollments. Consecutively enrolled patients undergoing successful HD treatments after PTA were randomly assigned to the FIR-radiated group or control group without radiation. FIR-radiated therapy meaning 40-minute radiation at the major lesion site or anastomosed site three times a week was continued until an end-point defined as dysfunction-driven re-PTA or the study end was reached.

Results: Of 216 participants analyzed, including 97 with arteriovenous grafts (AVG) (49 FIR-radiated participants and 48 control participants) and 119 with arteriovenous fistulas (AVF) (69 FIR-radiated participants and 50 control participants), the FIR-radiated therapy compared with free-radiated usual therapy significantly enhanced PTA-unassisted patency at 1 year in the AVG subgroup (16.3% vs. 2.1%; p < .01), but not the AVF subgroup (25.0% vs. 18.4%; p ¼ .50), and this accounted for the overall improved patency rates (21.4% vs. 10.3%; p ¼ .02).

Conclusions: This study suggests FIR-radiated therapy improves PTA-unassisted patency in patients with AVG who have undergone previous PTA.

-Eur J Vasc Endovasc Surg . 2013 Dec;46(6):726-32.

Effect of Far Infrared Therapy on Arteriovenous Fistula Maturation: An Open-Label Randomized Controlled Trial

Tue, 01 Oct 2013 03:28:32 GMT

Abstract

Background: Malfunction of the arteriovenous fistula (AVF) is an important cause of morbidity and hospitalization in hemodialysis (HD) patients. The aim of this study is to evaluate the effect of far infrared therapy on the maturation and patency of newly created AVFs in patients with chronic kidney disease stage 4 or 5.

Study Design: Randomized controlled study.

Setting & Participants: Patients with estimated glomerular filtration rate of 5–20 mL/min/1.73 m².

Intervention: 40 minutes of far infrared therapy 3 times weekly for a year.

Outcomes: The primary outcome is the rate of AVF malfunction within 12 months, with malfunction defined as either:
(1) thrombosis without thrill for AVFs not undergoing HD or
(2) receiving any type of interventional procedure due to a lower Kt/V (<1.2) for patients undergoing HD.

Secondary outcomes include:
(1) cumulative primary unassisted AVF patency, defined as time from creation of the AVF to the first episode of AVF malfunction;
(2) physiologic maturation of the AVF by the definition of AVF access blood flow (Qa) ≥500 mL/min and AVF diameter ≥4 mm at 3 months; and
(3) clinical maturation of the AVF suitable for HD at 1 year.

Measurements: AVF Qa was measured by Doppler ultrasonography at 2 days and 1, 2, 3, and 12 months.

Results: We enrolled 122 patients who were randomly allocated to the intervention (n = 60) and control (n = 62) groups. In comparison to controls, patients in the intervention group had higher Qa values at 1, 2, 3, and 12 months; a higher rate of physiologic maturation (90% vs 76%; P = 0.04) at 3 months; and a lower rate of AVF malfunction (12% vs 29%; P = 0.02) but higher rates of AVF cumulative unassisted patency (87% vs 70%; P = 0.01) and clinical maturation (82% vs 60%; P = 0.008) within 12 months.

Limitations: This is a single-center nonblinded study.

Conclusions: Far infrared therapy improves the access flow, maturation, and patency of newly created AVFs in patients with chronic kidney disease stages 4 and 5.

-Am J Kidney Dis. 62(2):304–311.

Length polymorphisms of heme oxygenase-1 determine the effect of far-infrared therapy on the function of arteriovenous fistula in hemodialysis patients: a novel physicogenomic study

Fri, 01 Feb 2013 03:39:11 GMT

Abstract

Background. The objective of this study was to evaluate the interaction between the length polymorphism of the guanosine thymidine repeat (GT)n(GT)ₙ(GT)n in the heme oxygenase-1 (HO-1) gene and far-infrared (FIR) therapy on access flow (Qa) and arteriovenous fistula (AVF) patency in hemodialysis (HD) patients.

Methods. A total of 280 HD patients were randomized into a control group (n = 141) and the FIR group (n = 139) who received 40 min of FIR therapy three times weekly for a year during the study period from May 2005 to December 2007. Access flow was measured during HD. The (GT)n(GT)ₙ(GT)n was determined with the definition of long (L) allele as (GT)n(GT)ₙ(GT)n ≥ 30 and short (S) allele as (GT)n(GT)ₙ(GT)n < 30.

Results. The Qa decreased from S/S to S/L and further to the L/L group but increased by FIR therapy with the highest Qa increase in the S/S group. The incidence of AVF malfunction decreased both from the L/L, S/L to S/S group (32.4% versus 17.2% versus 10.9%, P = 0.007) and from the control group to FIR group (27.5% versus 12.6%, P = 0.004). Significant associations were found between AVF malfunction and the following factors (hazard ratio, P-value): a past history of AVF malfunction (2.45, P = 0.044), FIR therapy (0.369, P = 0.03), and L/L genotypes of HO-1 (2.531 versus S/S + S/L genotypes). The 1-year unassisted patency decreased from 91.9% and 77.6% in S/S and S/L subgroups with and without FIR therapy to 75.8% and 60% for L/L subgroup with and without FIR therapy, respectively (P < 0.001).

Conclusions. FIR therapy improves Qa and patency of AVF in HD patients, with the best protective effect in those with S/S genotype of HO-1.

-Nephrol Dial Transplant (2013) 28: 1284–1293

FAR Infr-red Therapy

Tue, 01 May 2012 08:01:31 GMT

At City Hospitals Sunderland Renal Unit for the past 3 years we have been using FAR Infra-red Therapy to help mature arteriovenous fistulas also deal with the complications of fistulas during dialysis.

The therapy is easy to use during periods of dialysis as shown by fistula is very important to a patient on haemodialysis as it has good outcomes regarding decreased complications of infection and death as compared to neckline.

The technique of FAR Infra-red Therapy involves an emitter placed over the fistula surface, a mild heat sensation is generated but the mature the arteriovenous fistula and reduce clotting due to release of chemicals from the vessel wall.

In our experience, there have been no complications with this therapy over the last 3 years and we have had excellent feedback and presented our work nationally. Some of the patients now using the therapy on dialysis provide the following testimonials:- “FAR Infra-red therapy helps with pain on needling and it helps reduce bruising faster”. Another patient reports that “it helps reduce swelling and bruising more quickly than normal” and a third patient reports that “the reduction in pain on needling the fistula is substantial”. These and other effects of FAR Infra-red therapy reported by other Renal Units have helped us develop the service locally.

In Taiwan the FAR Infra-red Therapy has been used successfully for over 10 years

FAR Infra-red Therapy is used on each dialysis session for 40 minutes. The equipment is portable and easy to use for the nursing staff.

It has now been adopted as part of our routine work on haemodialysis for bruising of fistula maturation in the pre-dialysis clinic. We think this therapy is very useful and could easily be adopted widely in other Renal Units. Certainly the patients in our Renal Unit have welcomed it and gained significant benefit from its use.

The Vascular Access Nurse (Debbie Sweeney) has been vital into adopting this new technology in our Renal Unit and is happy to share her learning experiences.

Author's: Saeed Ahmed,

Site: City Hospital Sunderland NHS Foundation Trust

The original posted in Kidney Life, Winter issue 2012, P21

Far Infrared Therapy Inhibits Vascular Endothelial Inflammation via the Induction of Heme Oxygenase-1

Tue, 01 Jul 2008 04:03:16 GMT

Abstract

Objective —Survival of arteriovenous fistulas (AVFs) in hemodialysis patients is associated with both far infrared (FIR) therapy and length polymorphisms of the heme oxygenase-1 (HO-1) promoter. In this study, we evaluated whether there is an interaction between FIR radiation and HO-1 in regulating vascular inflammation .

Methods and Results —Treatment of cultured human umbilical vein endothelial cells (ECs) with FIR radiation stimulated HO-1 protein, mRNA, and promoter activity. HO-1 induction was dependent on the activation of the antioxidant responsive element/NF-E2-related factor-2 complex, and was likely a consequence of heat stress. FIR radiation also inhibited tumor necrosis factor-α-mediated expression of E-selectin, vascular cell adhesion molecule-1, intercellular cell adhesion molecule-1, monocyte chemoattractant protein-1, interleukin-8, and the cytokine-mediated adhesion of monocytes to ECs. The anti-inflammatory action of FIR was mimicked by bilirubin, and was reversed by the HO inhibitor, tin protoporphyrin-IX, or by the selective knockdown of HO-1. Finally, the anti-inflammatory effect of FIR was also observed in patients undergoing hemodialysis.

Conclusions —These results demonstrate that FIR therapy exerts a potent anti-inflammatory effect via the induction of HO-1. The ability of FIR therapy to inhibit inflammation may play a critical role in preserving blood flow and patency of AVFs in hemodialysis patients.

-Arterioscler Thromb Vasc Biol. 2008 April ; 28(4): 739–745.

Far-infrared irradiation can improve blood flow and patency of arteriovenous fistulas in hemodialysis patients

Mon, 01 Oct 2007 12:19:31 GMT

Commentary by Dr. Seiji Ohira

Original article Lin CC et al. (2007) Far-infrared therapy: a novel treatment to improve access blood flow and unassisted patency of arteriovenous fistula in hemodialysis patients. J Am Soc Nephrol 18: 985–992

A native arteriovenous fistula is the preferred method of vascular access in patients who require maintenance hemodialysis, even though intimal hyperplasia (which results in stenosis, and ultimately thrombosis) is unavoidable in this type of

access. In order to prevent these complications, we have made efforts at my institution to perform preoperative vascular mapping, allowing selection of the most appropriate vessels for fistula creation,1 and identification of the optimal

method of anastomosis for each individual patient. Scheduled postoperative monitoring is also necessary to detect early fistula failure and enable prompt surgical or endovascular repair.2 These steps are all important for maintenance of

adequate arteriovenous fistula function, but they have limited effects on fistula patency. The time has come, therefore, to try something other than surgical techniques to overcome the problem of fistula stenosis.

Only a few trials of nonsurgical approaches to prevent stenosis or restenosis of blood vessels have reported positive results. Kukita et al. found that endovascular iridium-192 irradiation during percutaneous transluminal angioplasty reduced the rate of restenosis.3 As a result of the equipment that this procedure requires, however, the number of facilities at which it can be performed is small; furthermore, there is controversy about its efficacy in preventing central venous restenosis in hemodialysis patients with arteriovenous fistulas.4 Lin et al. have carried out a well designed clinical study that used far-infrared radiation to prevent stenosis and prolong function

of arteriovenous fistulas, and they have reported very interesting and noteworthy results. They applied far-infrared radiation from 25 cm

above the surface of the fistula for 40 min during each thrice-weekly hemodialysis session. No patients complained of any adverse effects, such as skin burn or reaction to the radiation, at any point during the study.

It is important to note that the study has several limitations. First, the arteriovenous fistulas had higher rates of complications and

interventions than those reported elsewhere in the literature, and detailed background information for the patients is not provided. For

example, the authors omit to mention why the upper arm was selected for the site of fistula creation. Furthermore, there is no precise

description of the coverage area of irradiation.

We can speculate that far-infrared irradiation, as a heating therapy, causes rapid local vasodilation, thereby increasing access blood flow and potentially preventing thrombosis. This possibility does not, however, prove that far-infrared therapy was responsible for the blood flow increase observed by Lin et al. after 1 year. This increase could have derived from other desirable histological changes, such as a beneficial effect upon endothelial function. The authors’ speculation about inhibition of intimal hyperplasia and stimulation

of intimal repair as being the underlying mechanism is, however, based on reports such as that by Imamura et al.,5 which only show indirect evidence of such changes.

Before we can recommend far-infrared radiation as a means of prolonging the function of arteriovenous fistulas, we need to know exactly why the blood flow increase observed by Lin et al. was sustained, and what kind of histological changes are caused by this type of radiation. The potential benefits of far-infrared therapy on arteriovenous grafts should also be examined, as these accesses have higher stenosis and thrombosis rates than do arteriovenous fistulas.

S Ohira is a Vascular Surgeon and the Medical Director of Sapporo Kita Clinic, Sapporo, Japan.

-Ohira S. Nat Clin Pract Nephrol. 2007 Aug; 3(8): 422–423.

Far-Infrared Therapy: A Novel Treatment to Improve Access Blood Flow and Unassisted Patency of Arteriovenous Fistula in Hemodialysis Patients

Wed, 01 Aug 2007 04:04:14 GMT

Abstract

Vascular access malfunction, usually presenting with an inadequate access flow (Qa), is the leading cause of morbidity and hospitalization in hemodialysis (HD) patients. Many methods of thermal therapy have been tried for improving Qa but with limited effects. This randomized trial was designed to evaluate the effect of far-infrared (FIR) therapy on access flow and patency of the native arteriovenous fistula (AVF). A total of 145 HD patients were enrolled with 73 in the control group and 72 in the FIR group. A WS TY101 FIR emitter was used for 40 min, and hemodynamic parameters were measured by the Transonic HD02 monitor during HD. The Qa1 /Qa2 and Qa3 /Qa4 were defined as the Qa measured at the beginning/at 40 min later in the HD session before the initiation and at the end of the study, respectively. The incremental change of Qa in the single HD session with FIR therapy was significantly higher than that without FIR therapy (13.2 114.7 versus 33.4 132.3 ml/min; P 0.021). In comparison with control subjects, patients who received FIR therapy for 1 yr had (1) a lower incidence (12.5 versus 30.1%; P < 0.01) and relative incidence (one episode per 67.7 versus one episode per 26.7 patient-months; P 0.03) of AVF malfunction; (2) higher values of the following parameters, including (Qa4 Qa3 ) (36.2 82.4 versus 12.7 153.6 ml/min; P 0.027), (Qa3 Qa1 ) (36.3 166.2 versus 51.7 283.1 ml/min; P 0.035), (Qa4 Qa2 ) (99.2 144.4 versus 47.5 244.5 ml/min; P < 0.001), and (Qa4 Qa2 ) (Qa3 Qa1 ) (62.9 111.6 versus 4.1 184.5 ml/min; P 0.032); and (3) a better unassisted patency of AVF (85.9 versus 67.6%; P < 0.01). In conclusion, FIR therapy, a noninvasive and convenient therapeutic modality, can improve Qa and survival of the AVF in HD patients through both its thermal and its nonthermal effects.

- J Am Soc Nephrol 18: 985–992, 2007. doi: 10.1681/ASN.2006050534

far-infrared

FIRAPY Debuts at WHX Dubai 2026 with a Focus on Innovative Care for Dialysis Patients

“An Innovative Therapy for Dialysis Patients”

Strong Interest from Emerging and Established Markets

FIRAPY’s First Clinical Report Published in Oman

FIRAPY Showcases at the Chilean Society of Nephrology Annual Congress, Expanding Clinical Exchange in Latin America

FIRAPY Forum 2025 – Holistic Care for Dialysis Patients: Makes Life Better

FIRAPY Featured at the 24th JSVMR Annual Meeting with a Special Symposium and Two Research Presentations

FIRAPY Gains Momentum at the 70th JSDT Annual Meeting with 11 Research Presentations

FIRAPY Supports Clinical Research Advancing Non-Invasive Therapies for Peritoneal Dialysis

Long-Term Collaboration to Explore Non-Invasive Therapeutic Strategies

About the Latest Publication

Far-infrared therapy improves cardiovascular and infectious outcomes in peritoneal dialysis patients

Abstract

Introduction

Methods

Results

FIRAPY to Exhibit at 70th JSDT Annual Meeting in Yokohama

FIRAPY Showcased at ERA 2025 in Vienna

FIRAPY Expands Local Engagement in Thailand Through Two Key Vascular Access Events

First Step to Vascular Access Care Workshop – Chiang Mai ﻿

“Are Your Kidneys OK?” Kidney Health Awareness Event – Bangkok

FIRAPY at ERA 2025 – See You in Vienna!

FIRAPY Joins Dialysis Weekend 2025 in Pattaya with K2 Thailand

FIRAPY Presented at Thai Vascular Surgery Forum 2025

Join Us at the Taiwan Healthcare+ Expo 2024

Meet FIRAPY at Booth i1115a!

Improved Conditions of Couple Receiving Hemodialysis

Wife: Improvements in fine blood vessels

Husband: Doesn’t require surgery anymore

Exceptional vascular patency

Wife: Improvements in fine blood vessels

Husband: Doesn’t require surgery anymore

Application experiences in the hemodialysis center

Hemodialysis and Vascular Access

FIRAPY Showcased at OSNT Conference 2024 in Salalah, Oman

FIRAPY Showcased at OSNT Conference 2024 in Salalah, Oman

Far-infrared Therapy for Hemodialysis Patients

Abstract

Effect of far-infrared radiation therapy on von Willebrand factor in patients with chronic kidney disease

Abstract

Background ﻿

Methods

Results

Conclusions

Far infrared treatment on the arteriovenous fistula induces changes in sVCAM and sICAM in patients on hemodialysis

Abstract

Acute hemodynamic changes during far infrared treatment of the arteriovenous fistula in hemodialysis patients

Abstract

Far-Infrared Therapy Improves Arteriovenous Fistula Patency and Decreases Plasma Asymmetric Dimethylarginine in Patients with Advanced Diabetic Kidney Disease: A Prospective Randomized Controlled Tria

Abstract

Does Far-Infrared Therapy Improve Peritoneal Function and Reduce Recurrent Peritonitis in Peritoneal Dialysis Patients?

Abstract

The Effect of Far-Infrared Therapy on the Peritoneal Membrane Transport Characteristics of Uremic Patients Undergoing Peritoneal Dialysis: An Open-Prospective Proof-of-Concept Study

Abstract

The Effect of Far-Infrared Therapy on the Peritoneal Expression of Glucose Degradation Products in Diabetic Patients on Peritoneal Dialysis

Abstract

Double-Pokemon-Ball Sign in Encapsulating Peritoneal Sclerosis Responsive to Far-Infrared Therapy

Abstract

Far Infrared Therapy for Arterio Venous Fistula

Introduction

Complications of AVF

Protocol

Selection and recommendation

Exclusions

Pilot study

Criteria

Methodology/Measurement

Result (On-going study)

Conclusion

The effectiveness of far-infrared irradiation on foot skin surface temperature and heart rate variability in healthy adults over 50 years of age - A randomized study

Abstract

Background

Methods

Result

Conclusion

Effects of Far-Infrared Therapy on Foot Circulation Among Hemodialysis Patients With Diabetes Mellitus

Abstract

Background ﻿

Aim

First Step to Vascular Access Care Workshop – Chiang Mai

Background

Background

Case 1