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The life of fistula

A fistula is a hemodialysis patient’s lifeline. Hemodialysis is a treatment for kidney failure and the fistula makes life-saving hemodialysis treatments possible. A fistula lets large amounts of blood flow continuously during hemodialysis treatments to filter as much blood as possible per treatment. A quality of fistula is related to the quality of hemodialysis and the quality of hemodialysis is related to the patients’ quality of life. We divide the fistula in a different stage which we call the life of fistula. Firapy (WS™ Far-Infrared Therapy Unit) can play an important role in each stage and help to improve the quality of fistula.

What does Firapy (WS™ Far-Infrared Therapy Unit) can do for hemodialysis fistula?

Increase the success rate of fistula maturation

The one-month period after fistula procedure is the critical period for fistula maturation. FIRAPY (WS™ Far-infrared Therapy Unit) shortens maturation time, increases the fistula maturation success rate, improves fistula blood flow, and reduces the risk of fistula-related complications and the proportion of fistula failure.

Prolongs the life-span of the fistula

Human clinical trials have proven that long-term use of FIRAPY (WS™ Far-infrared Therapy Unit) extends the life-span of the fistula, decrease venous pressure, improves fistula blood flow, promotes circulation, prevents thrombosis formation, and reduces the number of surgeries required.

Improves fistula fibrosis

FIRAPY (WS™ Far-infrared Therapy Unit) rapidly relives bruising, hematoma, and cannulation related pain, improves fistula fibrosis, and reduces the probability of difficult cannulation. The treatment facilitates sweating, decreasing the burden on the body.

Alleviates discomfort after hemodialysis

Treatment to the palm area promotes peripheral autonomic nerve conduction, subsequently decreasing physical weakness, fatigue, chill, and numbness to the limbs after hemodialysis. It also effectively promotes circulation, maintains health, and relieves discomfort for long-term hemodialysis patients. It is easy to operate, safe, and convenient to learn, and therefore assists hemodialysis patients in self-care.

Experience Sharing from Medical Staff

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Hemodialysis and Vascular Access

Dr. Chun Zhong Liu

Jen-Ai Hospital

Head of Nephrology Department,

Hemodialysis Room, Taichung Branch

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Application experiences in the hemodialysis center

Dr. Yong-Xiang Hong

Taipei Neihu Hong Yong-Xiang Clinic, President

Tri-service General Hospital, Department of Nephrology, Clinic Physician

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A Helping Hand for the Nursing Staff in the Hemodialysis Room

Li-Ya Zheng, Group Leader

Han-Yang Clinic

Testimony from hemodialysis patients

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Improvement in the severe swelling of the arm

Patient: Narrated by Ms. Zhang

Symptoms: Painful and swollen fistula

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Improved Conditions of Couple Receiving Hemodialysis

Patient: Mr. & Mrs. Qiu

Symptoms: Extremely fine blood vessels

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Exceptional vascular patency

Patient: Mr. Wu (Narrated by his wife)

Symptoms: Consistent elevated blood pressure, unsmooth hemodialysis, fistula occlusion

The purpose mechanism of Firapy (WS™ Far-infrared Therapy Unit) in fistula care

Reference:

  1. Far-infrared therapy induces the nuclear translocation of PLZF which inhibits VEGF-induced proliferation in human umbilical vein endothelial cells. PLoS One. 2012;7(1):e30674.
  2. Far infrared therapy promotes ischemia-induced angiogenesis in diabetic mice and restores high glucose-suppressed endothelial progenitor cell functions. Cardiovasc Diabetol. 2012 Aug 15;11:99.
  3. Far-infrared therapy: a novel treatment to improve access blood flow and unassisted patency of arteriovenous fistula in hemodialysis patients. J Am Soc Nephrol. 2007 Mar;18(3):985-92.
  4. Far infrared therapy inhibits vascular endothelial inflammation via the induction of heme oxygenase-1. Arterioscler Thromb Vasc Biol. 2008 Apr;28(4):739-45.
  5. Length polymorphisms of heme oxygenase-1 determine the effect of far-infrared therapy on the function of arteriovenous fistula in hemodialysis patients: a novel physicogenomic study. Nephrol Dial Transplant. 2013 May;28(5):1284-93.
  6. Far Infrared Therapy Improves Endothelial Function and Access Flow of Newly-created AV Fistula in Patients WITH Stage 5 Chronic Kidney Disease. 2012 ERA-EDTA Congress poster. FP556.
  7. Effect of far infrared therapy on arteriovenous fistula maturation: an open-label randomized controlled trial. Am J Kidney Dis. 2013 Aug;62(2):304-11.
  8. Far Infrared Therapy-a Novel Treatment for AV Fistula Maturation and Maintenance? 2011 BRS poster.
  9. Biological effect of far-infrared therapy on increasing skin microcirculation in rats. Photodermatol Photoimmunol Photomed. 2006 Apr;22(2):78-86.

Q&A

Why is FIR therapy essential for Hemodialysis patients?

Far Infrared Therapy is a convenient, non-invasive physical therapy that carries on the Omni-directional care to hemodialysis patients’ vascular access.

What is the treatment protocol for using FIR therapy?

The AVF/AVG must be fully exposed (not covered with anything) to FIR

The FIR emitter should be placed 20~30 cm from the skin surface, directly above the AVF/AVG

Using FIR for 40 minutes during each hemodialysis session, and finishing the treatment 1 hour before the end of hemodialysis session.

Daily FIR therapy is recommended for daily care and acquiring best results.

Is FIR therapy suitable for all HD patients?

FIR is suitable for all HD patients, and is especially effective for the following patients:

New HD patients that just done the AVF/AVG surgery

Patients with low access blood flow

Patients with steal syndrome

Patients showing early signs of stenosis

Is FIR therapy effective for synthetic AV grafts?

Yes, FIR has been proven that it is able to improve PTA-unassisted patency in patients with AVG, and also clinically, improvements of access blood flow and dialysis venous pressure were observed on most AV graft patients after a few weeks.

New HD patients that just done the AVF/AVG surgery

Patients with low access blood flow

Patients with steal syndrome

Patients showing early signs of stenosis

When is the best time for HD patient to begin FIR therapy?

The best time for HD patient to begin FIR therapy is during the maturation period. If a patient begins daily FIR therapy after AVF surgery, not only will the surgery wound heal faster, the AVF will also mature sooner and better (2~3 weeks with daily use). In addition, the AVF is also likely to remain patent (free of stenosis and thrombosis) for longer.

Patients with low access blood flow

Patients with steal syndrome

Patients showing early signs of stenosis

What improvements can an HD patient expect after beginning FIR therapy?

Begin use prior to AVF surgery:

 FIR therapy can help make smaller blood vessels become more visible and more elastic, therefore, it’s able to improve success rate of surgery.

Begin use after AVF surgery (during maturation period):

 FIR therapy provides excellent post-surgery care including pain relief, anti-inflammation, reduction of bruising and swelling, and faster healing time.

 With daily FIR therapy, the fistula maturation time can be shortened, and future chances of AVF dysfunction (stenosis, thrombosis, etc.) may also be reduced.

Use during HD session:

 FIR therapy can help make venopuncture easier and less painful.

 Improve access blood flow and reduce dialytic venous pressure, which ultimately improves HD efficiency.

 FIR therapy can also be used to relieve muscle numbness or soreness that occurs during HD session.

Use after HD session (home care):

 FIR therapy can help relieve post-venopuncture hematoma and bruising, and help venopuncture wounds heal faster

 FIR therapy can help relieve the post-HD session fatigue

 FIR therapy can also be used on muscle/joint pain and soreness and improve circulation in the hands and feet.

For HD patients with Steal Syndrome:
FIR therapy can be applied to the hands to help ease the numbness and pain.

In summary, what are the benefits of equipping Firapy (WS™ Far Infrared Therapy Unit) at an HD center?

Patient Benefits

 Improved quality of life and quality of medical treatment

 Improved access blood flow that enhances dialysis efficiency

 Relief of venopuncture hematoma and pain

 Reduced vascular access complication related surgery and hospitalization

 Reduced medical cost spent on vascular access intervention, surgery, or hospitalization

 Reduced morbidity that may arise from surgery

 Long-term survival of vascular access

Dialysis Staff Benefits

 Safe and easy to operate, requires minimal training

 Additional tool for preventing vascular access dysfunction and failure

 Reduced emergencies due to poor access blood flow or access failures

 Help maintain dialytic venous pressure for efficient dialysis

Dialysis Clinic Benefits

 Enhanced clinic image of innovative and considerate patient care

 Competitive edge that can be used to recruit more patients

 Increased revenue by reducing missed dialysis treatments

 Increased staff efficiency by reducing time spent on access complications