Chen Chun-Fan, Lee Chiu-Yang, Chen Fu-An, Yang Chih-Yu, Chen Tz-Heng, Ou Shuo-Ming, Lee Kuo-Hua, Li Ching-Po, Chan Chia-Hao, Lee Pui-Ching, Chen Yung-Tai, Lee Tsung-Lun, Ho Yang, Chen Fan-Yu, Ma Hao-Wei, Chen Jinn-Yang, Tan Ann Charis, Li Szu-Yuan, Lin Chih-Ching
School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan.
Division of Nephrology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan 260, Taiwan.
J Clin Med. 2022 Jul 18;11(14):4168. doi: 10.3390/jcm11144168.
Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase and plays a significant role in the pathogenesis of arteriovenous fistula (AVF) dysfunction. The aim of this study is to evaluate the effect of far-infrared (FIR) therapy on the maturation and patency of newly-created AVFs in patients with advanced diabetic kidney disease (DKD) as well as the concurrent change in plasma ADMA. The study enrolled 144 participants with advanced DKD where 101 patients were randomly allocated to the FIR therapy group (N = 50) and control group (N = 51). Patients receiving FIR therapy had a decreased AVF failure rate within 12 months (16% versus 35.3%; = 0.027); decreased incremental change of ADMA concentration at the 3rd and 12th month; increased AVF blood flow at the 1st, 3rd, and 12th month; increased 3-month physiologic maturation rate (88% versus 68.6%; = 0.034); increased 1-year unassisted AVF patency rate (84% versus 64.7%; = 0.017); and increased clinical AVF maturation rate within 12 months (84% versus 62.7%; = 0.029) compared to the control group. The study demonstrates that FIR therapy can reduce the incremental changes in plasma ADMA concentration, which may be associated with the improvement of AVF prognosis in patients with advanced DKD.
不对称二甲基精氨酸（ADMA）是一氧化氮合酶的内源性抑制剂，在动静脉内瘘（AVF）功能障碍的发病机制中起重要作用。本研究的目的是评估远红外（FIR）疗法对晚期糖尿病肾病（DKD）患者新建立的AVF成熟度和通畅率的影响以及血浆ADMA的同时变化。该研究招募了144名晚期DKD参与者，其中101名患者被随机分配到FIR治疗组（N = 50）和对照组（N = 51）。接受FIR治疗的患者在12个月内AVF失败率降低（16%对35.3%；P = 0.027）；在第3个月和第12个月时ADMA浓度的增量变化降低；在第1个月、第3个月和第12个月时AVF血流量增加；3个月时生理成熟率增加（88%对68.6%；P = 0.034）；1年无辅助AVF通畅率增加（84%对64.7%；P = 0.017）；与对照组相比，12个月内临床AVF成熟率增加（84%对62.7%；P = 0.029）。该研究表明，FIR疗法可降低血浆ADMA浓度的增量变化，这可能与晚期DKD患者AVF预后的改善有关。
