Annals of Rehabilitation Medicine

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"Hemodialysis"

Original Articles

Carpal Tunnel Syndrome in Chronic Hemodialysis Patients.: Song, Yang Joo , Kim, Hyun Dong , Park, In Sun , Kim, Young Hun; J Korean Acad Rehabil Med 1998;22(5):1060-1064.

Abstract
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Objective: To investigate the prevalance of carpal tunnel syndrome (CTS) and polyneuropathy (PNP) in chronic hemodialysis patients, and to know the relationships between the clinical symptoms and electrophysiological evidence of CTS, the edema of the hand and CTS, and the shunt side and CTS.

Method: We carried out a standardized nerve conduction study on 30 patients who had undergone a chronic dialysis for varying lengths of time. Differential diagnosis between CTS and PNP was done on the basis of difference of the median-ulnar motor and sensory latencies in the patients with a prolonged distal median motor or sensory latency.

Results: Sixteen (54%) had a combined PNP with the CTS; Seven (23%) patients had a PNP only; Two (7%) patients had a CTS only. There was no definite findings of peripheral neuropathy in five (17%) patients. Among eighteen patients with the CTS, sixteen were subclinical and two were overt CTS. Presence of edema and shunt was not crucial for the development of CTS.

Conclusion: Prevalence of CTS in chronic hemodialysis patients was 60%. Subclinical CTS was more frequent compared to the overt CTS. Dialysis patients need a frequent nerve conduction study for the early identification of carpal tunnel syndrome and to avoid the irreversible nerve damage.

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The Correlation between Spondyloarthropathy and Peripheral Neuropathy in Chronic Renal Failure Patients Undergoing Hemodialysis.: Seok, Hyun , Lee, Hyuk Jin , Kim, Sang Hyun , Kim, Jun Lae , Lee, Hyuk , Kim, Jin Kook , Choi, Soo Jung , Park, Moo Yong; J Korean Acad Rehabil Med 2009;33(1):72-76.

Abstract
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Objective
To investigate the relationship between spondyloarthropathy and peripheral neuropathy in spinal pain patient undergoing hemodialysis due to chronic renal failure. Method: Subjects were 60 patients complaining posterior neck or back pain, undergoing regular hemodialysis for chronic renal failure. They were divided into two groups according to the radiologic findings: spondyloarthropathy group (SAG, n=28) and no-spondyloarthropathy group (NSAG, n=32). Nerve conduction studies of extremities, simple spinal radiologic examination and bone mineral density at the lumbar spine were taken. Results: Electrodiagnostic study revealed 26 patients (43%) had carpal tunnel syndrome, 32 (53%) had ulnar neuropathy, and 32 (53%) had peripheral polyneuropathy. Carpal tunnel syndrome was more frequent in SAG, but other neuropathic fingings, bone mineral density and duration of hemodialysis were not different between two groups. Conclusion: Nerve conduction study could be useful to screen the peripheral neuropathy in patients undergoing hemodialysis due to chronic renal failure. If they complained spinal pain, and diagnosed as spondyloarthropathy by radiologic examination, we might need to do electrodiagnostic study for early detection and treatment of carpal tunnel syndrome. (J Korean Acad Rehab Med 2009; 33: 72-76)