Enhanced autogenous arteriovenous fistula maturation in diabetic nephropathy with combined infrared irradiation and traditional Chinese Medicine soaking therapy

Diabetic Nephropathy (DN) is recognized as a prevalent microvascular complication among individuals with diabetes. In hemodialysis treatment, autologous arteriovenous fistula (AVF) is an ideal long-term vascular access due to its low infection rate and long lifespan. Patients (n = 84) requiring hemodialysis due to diabetic nephropathy who visited nephrology department of our hospital from March 2021 to May 2023 were divided into either a treatment group or a control group according to different treatment methods. The control group was treated with infrared irradiation after autologous AVF. The treatment group received supplementary treatment with Traditional Chinese Medicine (TCM) Soaking Therapy in addition to the standard protocol administered to the control group. The main outcome measures were fistula maturity rate and first use time. The diameter of the superficial vein, blood flow volume, thickness of the vessel wall, levels of serum NO, ET-1, PLT, FIB, D-D, CRP, IL-6, TNF-α, the complications after surgery were compared. The concentrations of CRP and IL-6were significantly attenuated in the intervention cohort relative to the control cohort, demonstrating a statistically significant reduction. The maturation rates of fistulas at 4 weeks and 8 weeks after surgery in the control group were 28.6 %(12 of 42) and 78.6 %(33 of 42), while those in the treatment group were 52.4 % (22 of 42) nd 97.6 % 41 of 42), and the average time to first use of the fistula in the treatment group was earlier 43.25 ± 6.63 vs 35.27 ± 5.39). The incidence of adverse reactions demonstrated a statistically significant reduction in the observation group. The combination of Chinese medicine soaking therapy and infrared radiation has significant effect on promoting the maturation of AVF in patients with diabetic nephropathy, and it can effectively reduce the level of serum inflammatory factors and the incidence of adverse reactions, this approach warrants broader utilization in clinical settings.