SP511FAR INFRARED THERAPY ENHANCES THE MATURATION OF ARTERIOVENOUS FISTULA IN PATIENTS WITH ADVANCED CHRONIC KIDNEY DISEASE THROUGH IMPROVING ENDOTHELIAL FUNCTION, VASCULAR INFLAMMATION, AND OXIDATIVE STRESS

Abstract

Introduction and Aims: We had demonstrated that far infrared (FIR) therapy could improve the access flow and unassisted patency of arteriovenous fistula (AVF) in prevalent HD patients; however, the effect of FIR on the endothelial function as well as the markers of inflammation and oxidative stress of the newly created AVF is unknown. Methods: We enrolled patients with advanced chronic kidney disease (CKD) by the definition of eGFR <20 ml/min/1.73m2. Patients were randomly and equally allocated to FIR group (receiving FIR therapy for 40 minutes thrice weekly for 3 months) and control group (without FIR therapy). This study is aimed to evaluate (1) the effect of newly-created AV access on the markers of inflammation (hsCRP), endothelial function [asymmetric dimethyl arginine (ADMA) and L-arginine], and oxidative stress [serum malondialdehyde (MDA), serum advanced oxidation protein products (AOPPs), blood glutathione (GSH), erythrocyte glutathione peroxidase (GPx), and erythrocyte superoxide dismutase (SOD) activities], (2) the effect of FIR on access flow and the levels of the above-mentioned inflammatory, endothelial and oxidative stress markers in patients with advanced CKD in the first 3 months after the creation of AVF. Results: Totally, 122 advanced CKD patients finished this study with 60 in FIR group and 62 in control group. In comparison with control patients, the patients in FIR group had lower mean values of incremental change of the plasma concentrations of hs-CRP (-0.68±0.93 vs. 0.39±0.46 mg/L, P=0.04) and ADMA (-0.10±0.05 vs. 0.02±0.05, P=0.02) but a higher incremental change of blood glutathione (2.45±2.23 vs. -0.44±0.67, P=0.031) and access flow of AVF from 1st to 3rd month. Conclusions: In patients with advanced stages of CKD, AVF malfunction is associated with a higher level of plasma hs-CRP, ADMA and a lower level of blood glutathione at baseline, which could be improved by FIR therapy. Henceforth, FIR therapy improves blood flow and the maturation of AVF possibly through the mechanism of correcting inflammation, endothelial dysfunction and oxidative stress.