School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Nephrol Dial Transplant. 2013 May;28(5):1284-93. doi: 10.1093/ndt/gfs608. Epub 2013 Jan 22.
The objective of this study was to evaluate the interaction between the length polymorphism of the guanosine thymidine repeat [(GT)n] in the heme oxygenase-1 (HO-1) gene and far-infrared (FIR) therapy on access flow (Qa) and arteriovenous fistula (AVF) patency in hemodialysis (HD) patients.
A total of 280 HD patients were randomized into a control group (n = 141) and the FIR group (n = 139) who received 40 min of FIR therapy three times weekly for a year during the study period from May 2005 to December 2007. Access flow was measured during HD. The [(GT)n] was determined with the definition of long (L) allele as [(GT)n] ≥ 30 and short (S) allele as [(GT)n] < 30.
The Qa decreased from S/S to S/L and further to the L/L group but increased by FIR therapy with the highest Qa increase in the S/S group. The incidence of AVF malfunction decreased both from the L/L, S/L to S/S group (32.4 versus 17.2 versus 10.9%, P = 0.007) and from the control group to FIR group (27.5 versus 12.6%, P = 0.004). Significant associations were found between AVF malfunction and the following factors (hazard ratio, P-value): a past history of AVF malfunction (2.45, P = 0.044), FIR therapy (0.369, P = 0.03) and L/L genotypes of HO-1 (2.531 versus S/S + S/L genotypes). The 1-year unassisted patency decreased from 91.9 and 77.6% in S/S and S/L subgroups with and without FIR therapy to 75.8 and 60% for L/L subgroup with and without FIR therapy, respectively (P < 0.001).
FIR therapy improves Qa and patency of AVF in HD patients, with the best protective effect in those with S/S genotype of HO-1.
本研究旨在评估血红素加氧酶-1（HO-1）基因鸟嘌呤胸腺嘧啶重复（GT）n 长度多态性与远红外线（FIR）治疗对血液透析（HD）患者流量（Qa）和动静脉瘘（AVF）通畅率的相互作用。
共 280 例 HD 患者在 2005 年 5 月至 2007 年 12 月期间被随机分为对照组（n = 141）和 FIR 组（n = 139），对照组在研究期间每周接受 3 次共 40 分钟的 FIR 治疗，共 1 年。在 HD 期间测量 Qa。GTn 以长（L）等位基因定义为 GTn≥30，短（S）等位基因为 GTn<30。
从 S/S 到 S/L 再到 L/L 组，Qa 降低，但 FIR 治疗后增加，S/S 组 Qa 增加最多。AVF 功能障碍的发生率从 L/L、S/L 组降低到 S/S 组（32.4%、17.2%、10.9%，P=0.007），从对照组降低到 FIR 组（27.5%、12.6%，P=0.004）。AVF 功能障碍与以下因素显著相关（风险比，P 值）：AVF 功能障碍的既往史（2.45，P=0.044）、FIR 治疗（0.369，P=0.03）和 HO-1 的 L/L 基因型（2.531 与 S/S+S/L 基因型）。1 年无辅助通畅率从 S/S 和 S/L 亚组有和无 FIR 治疗分别为 91.9%和 77.6%，降低至 L/L 亚组有和无 FIR 治疗分别为 75.8%和 60%（P<0.001）。
FIR 治疗可改善 HD 患者的 Qa 和 AVF 通畅率，HO-1 的 S/S 基因型患者具有最佳的保护作用。
