Kidney Week

Abstract: FR-PO522

Far Infrared Radiation Does Not Improve Time to Cannulation in Newly Placed Arteriovenous Fistulas in Patients on Hemodialysis

Session Information

• Dialysis Vascular Access
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 803 Dialysis: Vascular Access

Authors

• Lindhard, Kristine, Herlev Hospital, Herlev, Hovedstaden, Denmark

Kristine Lindhard, MD

• Hansen, Henrik Post, Herlev Hospital, Herlev, Hovedstaden, Denmark

Henrik Post Hansen, MD

• Gliese, Kirstine Moeller, Sjaellands Universitetshospital Roskilde, Roskilde, Sjaelland, Denmark

Kirstine Moeller Gliese, MD

• Hansen, Emilie Klara, Herlev Hospital, Herlev, Hovedstaden, Denmark

Emilie Klara Hansen

• Hommel, Kristine, Holbaek Sygehus, Holbaek, Sjaelland, Denmark

Kristine Hommel, MD, PhD

• Jensen, Boye, Syddansk Universitet, Odense, Syddanmark, Denmark

Boye Jensen, MD, PhD

• Liem, Ylian Serina, Rigshospitalet, Kobenhavn, Denmark

Ylian Serina Liem, MD, PhD

• Pedersen, Brian Lindegaard, Rigshospitalet, Kobenhavn, Denmark

Brian Lindegaard Pedersen, MD, PhD

• Pourarsalan, Mahshid, Nordsjaellands Hospital, Hillerod, Denmark

Mahshid Pourarsalan, MD

• Rix, Marianne, Rigshospitalet, Kobenhavn, Denmark

Marianne Rix, MD, PhD

• Heaf, James, Sjaellands Universitetshospital Roskilde, Roskilde, Sjaelland, Denmark

James Heaf

• Hansen, Ditte, Herlev Hospital, Herlev, Hovedstaden, Denmark

Ditte Hansen, MD, PhD

Background

There is a need to improve arteriovenous fistula (AVF) maturation and decrease the number of central venous catheter days in patients on hemodialysis (HD). Far infrared radiation (FIR) is a treatment modality, which may improve AVF maturation and patency. The present trial examined FIR's effect on AVF maturation

Methods

A randomized, controlled, open-label clinical trial was performed. Patients were randomized to receive FIR treatment (FIR) or no FIR (control). After AVF placement, the FIR group received FIR on their AVF for 40 minutes at every HD treatment for one year. The primary outcome was the difference in time to cannulation, defined as the number of days from AVF placement to the first HD treatment with two functioning dialysis needles in the AVF. The difference was explored in a Kaplan-Meier analysis censored for thrombosed AVFs, death, loss to follow-up, and change of renal replacement therapy. Hazard ratios (HR) were determined by Cox regression analyses and adjusted for age, sex, diabetes, cardiovascular disease, albumin, type of AVF, size of AVF in mm at placement, and peroperativ flow.

Results

In total, 91 patients were randomized to FIR (n=46) or control (n=45). There were no differences in baseline characteristics between groups. No significant difference in time to cannulation with median days of 68 days [52;109.5] in the FIR group and 68 days [56.5;85] in the control group (p=0.8) was seen. The HR for chance of cannulation was 0.71; (95% confidence interval (CI), 0.43-1.18, p=0.19) in the FIR group compared to the control group. HR after adjustment for clinical variables was 0.68 (95% CI 0.40-1.15, p=0.12) in the FIR group compared to the control group. The number of thrombosed AVFs before cannulation was 9 in the FIR group and 4 in the control group (p=0.23)

Conclusion

FIR does not improve time to cannulation in newly placed AVFs in patients on hemodialysis. However, the influence of FIR on clinical maturation, the long-term risk of thrombosis, and the number of interventions in the AVFs are yet to be explored.

Funding

• Private Foundation Support