The Same Practice, Tested Two Ways: What a Dialysis Trial Without a Sham Arm Can and Cannot Tell Us

Key Takeaways

• Seventy-four haemodialysis patients across three centres were randomised: thirty-seven received ten Reiki sessions over five weeks, thirty-seven received routine treatment only.
• Pain, fatigue and itching all fell significantly in the Reiki group. Itching rose significantly in the control group.
• The control group received no sham session, which means the trial cannot separate Reiki from the effect of someone being present and attentive for thirty minutes, ten times.

Key Terms Explained

• 靈氣 (Reiki) / Universal Energy — Connecting with the energy of the universe and letting it settle life in a better direction.
• 霊授 (Reiju) / Attunement — The transmission given in person by a teacher, traditionally the true beginning of a practitioner's path.
• 師範 (Shihan) / Master Teacher — The level qualified to teach and to give attunement in the traditional lineage.
• Sham control — A convincing imitation of the treatment, so that participants cannot tell which group they are in.
• Routine-care control — A group that receives only their usual treatment, with no substitute session at all.

Two Trials, One Practice, Different Conclusions Available

A few days ago I wrote about an intensive care trial in which patients on ventilators received either a thirty-minute Reiki session or a sham session performed by someone with no training and no intent. The results favoured the Reiki group.

This week I want to look at a different study, because the contrast between them teaches more than either does alone.

The design choice that separates them is a single line in the methods section, and it is the line most readers skip.

Related: Reiki Tested in an Intensive Care Unit: An Honest Read of a Sham-Controlled Trial on Ventilated Patients explains this in detail.

What the Dialysis Study Did

Two features are worth noticing before the results.

Ten sessions, not one. This is a course of treatment rather than a single encounter, which is much closer to how Reiki is actually used. Most trials measure one session because it is easier to run.

The control group received nothing extra. They had their usual dialysis treatment. Nobody sat with them for thirty minutes twice a week doing anything at all.

Related: Reiki in the ICU: An Honest Reading of a 2026 Sham-Controlled Trial on Ventilated Patients explains this in detail.

The Reported Results

The itching row is the one that caught my attention.

Persistent itching is a well-known and miserable feature of long-term dialysis. In this trial it did not merely fail to improve in the control group — it got worse over the five weeks, significantly so. In the Reiki group it fell.

A divergence in both directions is a stronger signal than an improvement in one group alone, and it is the most interesting number in the study.

Related: 272 Patients, No Difference: Reading the Largest Reiki Trial That Found Nothing explains this in detail.

And Now the Problem

Here is where I have to be as sceptical about a favourable result as I would be about an unfavourable one.

There was no sham arm.

The Reiki group received ten thirty-minute sessions in which a trained practitioner was present, attentive and quiet. The control group received none. So the trial compares "Reiki plus a person's undivided attention, ten times" against "nothing extra."

Anything that follows from being visited regularly by a calm person for five weeks is inside the result and cannot be separated out. Dialysis is long, tedious and isolating. Ten scheduled half-hours of unhurried human attention is not a small intervention in that setting, whatever else is or is not happening.

This is not a criticism of the researchers. Sham-controlled designs are harder to run and harder to get approved, and a routine-care comparison is a legitimate first step. But it strictly limits what the numbers support.

What the study does show: patients who received this programme did better on pain, fatigue and itching than patients who did not.

What it does not show: that the improvement came from Reiki rather than from attention, routine, expectation, or the simple fact of being included in something.

The ICU study I wrote about earlier had a sham arm, and so it could speak to that question — for one session, in one setting, with sixty patients. This study has more sessions and a more realistic treatment course, and cannot. Neither is the better study. They answer different questions, and both answers are partial.

Why I Keep Insisting on This

I have practised daily for over twenty years and I teach this. It would be easy, and commercially convenient, to present a table of significant results and move on.

The reason I do not is that the sceptical reader is the only reader worth convincing, and that reader will find the missing sham arm in thirty seconds. A summary that omits it does not persuade them; it tells them the writer either did not read the methods or hoped they would not.

There is also a practical reason. Practitioners who learn to read these studies honestly are far better at answering the questions that actually come up — from a nurse, from a family member, from a hospital administrator deciding whether to allow a volunteer programme. "The trial showed a benefit against routine care, and it could not separate the practice from the attention" is an answer that survives follow-up questions. "It's been proven" does not.

My own claim has not moved. Reiki is not medical care. It does not diagnose or treat anything, and I make no claims about illness. What I will say is that patients in this trial who received the sessions reported less pain, less fatigue and less itching than those who did not, and that this is worth someone running the sham-controlled version.

How to Read the Next One You See

The first row does most of the work. Routine care, sham, or another active treatment — that single fact tells you the boundary of what the study can claim, before you read a single result.

The fourth row is worth adding to your habits. The itching result in this trial is more informative than the pain result precisely because it moved in opposite directions, and that kind of detail lives in the tables rather than the summary.

FAQ

Q: Does a trial without a sham arm count for nothing? A: Not at all. It establishes that a programme produced better outcomes than no programme, which is a real and useful finding — particularly for someone deciding whether to offer sessions in a clinic. It simply cannot tell you which ingredient did the work.

Q: Is ten sessions more meaningful than one? A: For anyone thinking about how Reiki is actually used, yes. A single session is easy to study and unlike normal practice. A five-week course is closer to what a practitioner would offer and what a patient would experience.

Q: Why did itching get worse in the control group? A: The study reports the increase without my being able to explain it, and I will not invent a mechanism. Persistent itching is a common problem in long-term dialysis and it may simply have followed its usual course over five weeks. That the Reiki group moved the other way is the observation; the reason is not established here.

Q: Should dialysis units offer Reiki on the basis of this? A: That is a decision for clinicians working from the whole body of evidence, and consent arrangements deserve as much attention as results. If a unit does decide to, the honest framing is that patients in a trial of this programme reported improvement, not that Reiki has been shown to treat anything.

Q: How do these two studies fit together? A: One had a sham arm and a single session; the other had a realistic course of treatment and no sham. Between them they gesture at the same direction from different angles, and neither settles it. The study still missing is the one with both — a full course, sham-controlled.

Key Insights to Remember

• The composition of the control group sets the ceiling on what any trial can claim, and it is one sentence in the methods. Learn to find it first. A favourable result against routine care and a favourable result against sham are different findings, and treating them as the same is the most common error in how this research gets repeated.
• Results that move in opposite directions carry more information than results that improve in one group. The itching finding in this trial — down in one arm, significantly up in the other — is the number I would want a larger study to chase, and it is the one least likely to appear in a summary.
• Reading these papers honestly is a practical skill, not a display of rigour. The people who ask practitioners hard questions are nurses, administrators and families, and they ask follow-ups. An answer built on what a study actually established holds up under those; an answer built on a headline does not.

Sources

• Investigation of the Effect of Reiki on Pain, Fatigue, and Itching in Hemodialysis Patients: Randomized Controlled Trial — Hemodialysis International (Wiley)
• Investigation of the Effect of Reiki on Pain, Fatigue, and Itching in Hemodialysis Patients — PubMed
• Reiki: What You Need To Know — National Center for Complementary and Integrative Health (NCCIH)