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