Date of Award

2015

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not far infrared therapy reduces the incidence of arteriovenous fistula (AVF) malfunction in patients with renal disease undergoing hemodialysis.

STUDY DESIGN: Review of three primary randomized controlled trial studies published from 2007-2013.

DATA SOURCES: Three peer-reviewed randomized controlled trials studying the effectiveness of far infrared therapy in the preservation of native arteriovenous fistula function in patients with chronic kidney disease requiring hemodialysis. Data searches done in PubMed, CINAHL Plus and EBSCOhost.

OUTCOMES MEASURED: Primary outcome measured was episodes of AVF malfunction due to stenotic complication. After randomization, patient outcomes were monitored and recorded over the span of 12 months to assess the effectiveness of far infrared therapy at preventing AVF malfunction. AVF malfunction was defined as any stenosis-related change in the AVF resulting in blood flow rate /min (which requires surgical intervention or angioplasty). Infection, aneurysm formation and steal syndrome were not considered stenosis-related.

RESULTS: All three articles demonstrated a lower incidence of AVF malfunction in patients treated with far infrared therapy. The studies in question demonstrated zero incidence of any adverse effect.

CONCLUSIONS: This review reinforces the author’s conclusions that FIR therapy, a non-invasive technique, is a useful modality for the prevention of complications requiring surgical intervention and the preservation of arteriovenous fistulas. These conclusions should not be extrapolated to patients with artificial AV grafts.

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