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<p>Far-infrared (FIR) therapy has been proposed to improve vascular access flow (Qa) in maintenance hemodialysis patients with an arteriovenous fistula (AVF) or arteriovenous graft (AVG). However, vascular access blood flow measurements may be difficult to interpret because of within-patient measurement variability. We prospectively evaluated Qa changes after FIR therapy and applied minimal detectable change at the 95% confidence level (MDC95) to assess reliable response. Forty-two maintenance hemodialysis patients with AVF or AVG received FIR therapy during hemodialysis for 40&#xa0;min per session, three times weekly, for 3 months. Baseline Qa was calculated from three repeated pre-treatment measurements. Mean Qa increased from 1,004.3 ± 451.1 to 1,159.9 ± 668.9 mL/min at 3 months; this difference was significant in paired analysis, but not in linear mixed-effects, non-parametric, average post-treatment, or outlier-excluded analyses. The global within-patient SD of baseline Qa was 248.34 mL/min, yielding an MDC95 threshold of 688.36 mL/min. Although 21 patients (50.0%) showed any average post-treatment Qa increase, only 1 (2.4%) met the global MDC95 criterion and 3 (7.1%) met individual MDC95 criteria. The nominally significant paired increase in Qa was not robust across mixed-effects and sensitivity analyses, and reliably detectable individual increases were uncommon after accounting for within-patient variability.</p>

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Far-infrared therapy and vascular access flow in hemodialysis patients with arteriovenous fistula or graft: a prospective minimal detectable change analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月21日

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  • Eun Jung Kim,
  • Soh Yeon Kim,
  • Youn Kyung Kee,
  • Hayne Cho Park,
  • Sua Lee,
  • Young-Ki Lee,
  • Jinseog Kim,
  • Do Hyoung Kim

摘要

Far-infrared (FIR) therapy has been proposed to improve vascular access flow (Qa) in maintenance hemodialysis patients with an arteriovenous fistula (AVF) or arteriovenous graft (AVG). However, vascular access blood flow measurements may be difficult to interpret because of within-patient measurement variability. We prospectively evaluated Qa changes after FIR therapy and applied minimal detectable change at the 95% confidence level (MDC95) to assess reliable response. Forty-two maintenance hemodialysis patients with AVF or AVG received FIR therapy during hemodialysis for 40 min per session, three times weekly, for 3 months. Baseline Qa was calculated from three repeated pre-treatment measurements. Mean Qa increased from 1,004.3 ± 451.1 to 1,159.9 ± 668.9 mL/min at 3 months; this difference was significant in paired analysis, but not in linear mixed-effects, non-parametric, average post-treatment, or outlier-excluded analyses. The global within-patient SD of baseline Qa was 248.34 mL/min, yielding an MDC95 threshold of 688.36 mL/min. Although 21 patients (50.0%) showed any average post-treatment Qa increase, only 1 (2.4%) met the global MDC95 criterion and 3 (7.1%) met individual MDC95 criteria. The nominally significant paired increase in Qa was not robust across mixed-effects and sensitivity analyses, and reliably detectable individual increases were uncommon after accounting for within-patient variability.