Chang Yuanmay, Chang Jui-Ting, Lee Mei-Yi, Huang Mei-Zen, Chao Yann-Fen C C, Shih Yung-Luen, Hwang Yao-Rong
Institute of Long-Term Care, MacKay Medical College, New Taipei 25245, Taiwan.
Division of Nephrology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan.
J Clin Med. 2022 Mar 15;11(6):1624. doi: 10.3390/jcm11061624.
The use of peritoneal dialysis in end-stage renal disease is increasing in clinical practice. The main purpose of this study was to evaluate the effect of far-infrared radiation therapy on inflammation and the cellular immunity of patients undergoing peritoneal dialysis. We recruited 56 patients undergoing peritoneal dialysis, and we included 32 patients for the experimental group and 24 patients from the control group in the final analysis. The experimental evaluation in our study was as follows: (1) We used abdominal computed tomography to explore the changes in abdominal blood vessels. (2) We compared the effects of peritoneal dialysis using blood glucose, HbAlC, albumin, urea nitrogen, creatinine, white blood cells, hs-CRP; peritoneal Kt/V of peritoneal function, and eGFR. (3) We compared the cytokines’ concentrations in the two groups while controlling for the other cytokines. Results and Discussion: (1) There was no significant difference in the abdominal blood vessels of the experimental group relative to the control group according to abdominal CT over the 6 months. (2) Our study demonstrates statistically significant effects of FIR therapy on the following parameters: creatinine (p = 0.039 *) and hs-CRP (p < 0.001 **) levels decreased significantly, and eGFR (p = 0.043 *), glucose (p < 0.001 **), and albumin (p = 0.048 *) levels increased significantly. Our study found that in the experimental group, creatinine and hs-CRP levels decreased significantly due to FIR therapy for 6 months. However, our study also found that the glucose level was significantly different after FIR therapy for 6 months. Peritoneal dialysis combined with FIR can reduce the side effects of the glucose in the dialysis buffer, which interferes with peritoneal inflammation and peritoneal mesothelial cell fibrosis. (3) In addition, we also found that no statistically significant difference in any inflammatory cytokine after FIR therapy. IFN-γ (p = 0.124), IL-12p70 (p = 0.093), IL-18 (p = 0.213), and TNF-α (p = 0.254) did not exhibit significant improvements after peritoneal dialysis with FIR treatment over 6 months. Conclusions: We found that the effectiveness of peritoneal dialysis was improved significantly with FIR therapy, and significant improvements in the peritoneal permeability and inflammatory response were observed.
在临床实践中，终末期肾病患者使用腹膜透析的情况正在增加。本研究的主要目的是评估远红外辐射疗法对接受腹膜透析患者的炎症和细胞免疫的影响。我们招募了56例接受腹膜透析的患者，最终分析纳入实验组32例患者和对照组24例患者。我们研究中的实验评估如下：（1）我们使用腹部计算机断层扫描来探究腹部血管的变化。（2）我们比较了使用血糖、糖化血红蛋白、白蛋白、尿素氮、肌酐、白细胞、超敏C反应蛋白进行腹膜透析的效果；腹膜功能的腹膜Kt/V以及估算肾小球滤过率。（3）在控制其他细胞因子的同时，我们比较了两组中的细胞因子浓度。结果与讨论：（1）根据腹部CT，在6个月内，实验组相对于对照组的腹部血管没有显著差异。（2）我们的研究表明，远红外辐射疗法对以下参数具有统计学显著效果：肌酐（p = 0.039 *）和超敏C反应蛋白（p < 0.001 **）水平显著降低，估算肾小球滤过率（p = 0.043 *）、血糖（p < 0.001 **）和白蛋白（p = 0.048 *）水平显著升高。我们的研究发现，在实验组中，由于进行了6个月的远红外辐射疗法，肌酐和超敏C反应蛋白水平显著降低。然而，我们的研究还发现，在进行6个月的远红外辐射疗法后，血糖水平存在显著差异。腹膜透析联合远红外辐射可以减少透析缓冲液中葡萄糖的副作用，而这种副作用会干扰腹膜炎症和腹膜间皮细胞纤维化。（3）此外，我们还发现，远红外辐射疗法后，任何炎症细胞因子均无统计学显著差异。在进行6个月的腹膜透析联合远红外辐射治疗后，干扰素-γ（p = 0.124）、白细胞介素-12p70（p = 0.093）、白细胞介素-18（p = 0.213）和肿瘤坏死因子-α（p = 0.254）均未表现出显著改善。结论：我们发现，远红外辐射疗法显著提高了腹膜透析的有效性，并且观察到腹膜通透性和炎症反应有显著改善。
