J Korean Soc Surg Hand.  2015 Sep;20(3):89-95. 10.12790/jkssh.2015.20.3.89.

Carpal Tunnel Syndrome in Patients Undergoing Long-Term Hemodialysis Therapy: Clinical Characteristics and Results of Surgical Treatment

• Park H
• Lee DS
• Yun TK
• Ahn DS

• KMID: 2068813
• DOI: http://doi.org/10.12790/jkssh.2015.20.3.89

Abstract

PURPOSE
Carpal tunnel syndrome (CTS) has become increasingly recognized as a complication of long-term hemodialysis. This study evaluated the clinical characteristics and compared the results of carpal tunnel release for CTS patients with or without hemodialysis.
METHODS
We retrospectively reviewed the clinical characteristics and surgical outcomes of 49 chronic hemodialysis patients with 83 CTS hands. Also, 100 patients were selected for the control group. Patient characteristics, accompanying systemic conditions, operative outcomes were compared.
RESULTS
In hemodialysis group, the mean age and hemodialysis duration were 59.5+/-10.5 years and 4.1+/-2.5 years, respectively. Of the 83 hands with CTS, 45 (54.2%) had arteriovenous fistulas, while 38 (45.7%) did not (p=0.02). Most (81.6%) of the patients reported symptom improvement after surgical treatment, and the remaining patients (18.4%) reported persistent and recurrent symptoms. Rates of remaining symptoms and reoperations were significantly higher in the CTS patients with hemodialysis group.
CONCLUSION
Majority of CTS patients with hemodialysis have much improved after transverse carpal ligament release. However, they showed higher recurrence than idiopathic CTS patients. In recurrent patients, use of the extended carpal tunnel release is effective in symptom relief.

Keyword

Carpal tunnel syndrome; Hemodialysis; Chronic kidney failure

MeSH Terms

Arteriovenous Fistula
Carpal Tunnel Syndrome*
Hand
Humans
Kidney Failure, Chronic
Ligaments
Recurrence
Renal Dialysis*
Retrospective Studies

Figure

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  Fig. 1. Patient inclusion and exclusion criteria. 49 chronic renal failure patients who were on hemodialysis and followed-up more than 1 year were included in hemodialysis group. Among 3,275 patients who were without chronic renal failure and diagnosed with carpal tunnel syndrome, 100 was selected randomly and categorized as the “Without dialysis group”.

Reference

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