The Effects of Iontophoretic Injections of Salvia miltiorrhiza on the Maturation of the Arteriovenous Fistula: A Randomized, Controlled Trial

Context For patients undergoing hemodialysis, the native arteriovenous fistula (AVF) is the primary approach to vascular access (VA). VA failure is the main cause of morbidity and mortality in hemodialysis patients. It has been reported in recent studies that the primary failure rate can be as high as 50%. Objective The study investigated the effects of iontophoretic administration of Salvia miltiorrhiza (SM) on the maturation of the AVF. Design The study was a randomized, controlled trial. Setting The study occurred in Guangdong Provincial Hospital of Traditional Chinese Medicine (Guangzhou, China). Participants Participants were 40 patients with chronic kidney disease at stage 4 or 5. Intervention Participants were randomly assigned to one of 2 groups (n = 20 each) after they had received an AVF operation. Patients in the control group were given routine care, and patients in the intervention group were given routine nursing in combination with an iontophoretic SM injection on a targeted area of the fistula after surgery. Outcome Measures The blood flow of the AVF, the diameter of the artery vein shunt, and the thickness of the AVF from the vascular wall to the skin were observed. Results The maturation rates of the AVFs after 1 mo were 50% and 85% in the control group and the intervention group, respectively. A significant difference existed between the 2 groups (P < .05). The results of the surgery were significantly different for the control and intervention groups, with the blood flows of the AVF being 1182.05 +/- 547.10 mL/min and 705.55 +/- 278.63 mL/min (P <.05), respectively, and the diameters of the artery vein shunts being 4.51 +/- 1.47 mm and 3.54 +/- 0.67 mm (P < .05), respectively, after treatment. Conclusions Iontophoretically mediated, transdermal delivery of an SM injection to a targeted area of the AVF can significantly shorten the time to maturity of the fistulae.