Carpal Tunnel Syndrome: a Major Complication in Hemodialysis Patients

Sívrí, A.; Çeliker, Reyhan; Sungur, Cem; Yg, Kutsal

doi:10.3109/03009749409103731

Cited by 19 publications

(18 citation statements)

References 9 publications

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“…However, an established CTS can be treated with a splint to the wrist or by early decompression of the tunnel. Late decompression in patients with a long history of sensory or motor symptoms is of limited benefit or improvement may be non-existent; similarly, local anaesthetic injection [11] or corticosteroids bring only temporary relief [11,12,13]. Repeat carpal tunnel release in recurrent CTS is difficult to perform and often less beneficial [12, 13], and to improve results in such revision surgeries, removal of flexor digitorum superficialis tendons III and IV has been performed [19].…”

Section: Discussionmentioning

confidence: 99%

“…Radiographic imaging, computed tomography, magnetic resonance imaging [6] and ultrasonic evaluation can further assist in the evaluation and progression of the disease and may help to identify pathological fractures often seen in this group of patients [7, 8]. Release of carpal tunnel is frequently performed for the relief of symptoms, but there is a paucity of studies describing objective efficacy of the procedure in this group of patients [9,10,11,12,13]. The current retrospective study involves postoperative assessment of five main symptoms associated with amyloid-associated CTS in patients on haemodialysis.…”

Section: Introductionmentioning

confidence: 99%

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An Assessment of Symptomatic Relief after Carpal Tunnel Release in Patients on Haemodialysis

Khan

2008

Nephron Clin Pract

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Patients receiving haemodialysis for chronic kidney disease are at risk of developing β₂-microglobulin-related carpal tunnel syndrome (CTS). There is a lack of evidence regarding outcome of this complication following surgical treatment. The current study specifically addressed the relief of symptoms after carpal tunnel release in this particular group of patients. Materials and Method: 26 carpal tunnel release operations were performed in 19 patients (12 males, 7 females) between 1992 and 1996. The mean age of the patients was 59 years (range 41–78) with a mean duration of haemodialysis of 12.6 years. Patients were dialysed the day before surgery with low-dose heparin. All procedures were performed using 1% Xylocaine with adrenaline 1:200,000 without tourniquet as day cases. Relief of weakness of the hand, tingling, pain at rest, pain on use, nocturnal paraesthesiae and scar pain were assessed. Results: All outcome measures showed marked improvement and 84% (16/19) of patients were satisfied with the outcome. One patient showed worsening of pain at rest and pain on use of hand. Conclusion: Release of carpal tunnel in patients on haemodialysis helps alleviation of symptoms due to median nerve compression and improves the function of hand and quality of life in the majority of patients. There can still be a small minority of patients who may not show any improvement and a few may rarely get worse.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An Assessment of Symptomatic Relief after Carpal Tunnel Release in Patients on Haemodialysis

Khan

2008

Nephron Clin Pract

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“…CTS is a common complication in patients undergoing long-term hemodialysis [5,6,[8][9][10]18]. The prevalence of CTS correlates with the duration of hemodialysis [5,8], and CTS reportedly affects 32% to 50% of patients more than 10 years after the start of hemodialysis [8,14] and 80% over 30 years [14].…”

Section: Introductionmentioning

confidence: 99%

“…Surgical release of the transverse carpal ligament is commonly performed in patients with severe symptoms of hemodialysis-associated CTS [6,9,13,[15][16][17][18]. Approximately 5% of patients receiving hemodialysis have reported a history of carpal tunnel release [16].…”

Section: Introductionmentioning

confidence: 99%

Does Carpal Tunnel Release Provide Long-Term Relief in Patients with Hemodialysis-Associated Carpal Tunnel Syndrome?

Kang

Koh

Lee

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Carpal tunnel syndrome (CTS) is a common complication in patients receiving long-term hemodialysis. In the short-term however, these patients are less likely to have pain relief and restoration of function after carpal tunnel release. However, it is unclear whether patients who have release for hemodialysis-associated CTS have differing persisting relief of symptoms compared with patients with idiopathic CTS. Questions/purposes We therefore compared (1) the severity of pain and level of function in patients who had release for hemodialysis-associated CTS with scores of patients who had release for idiopathic CTS, and (2) the operation-related complications. Methods We retrospectively reviewed 36 patients with CTS who were receiving hemodialysis and 54 patients with idiopathic CTS. Control subjects were matched for age, gender, and symptom severity. We obtained Boston Carpal Tunnel Questionnaire (BCTQ) scores preoperatively and at each followup. The minimum followup was 24 months (mean, 44.3 months; range, 24-90 months), although all comparisons were made at 2 years.

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“…In clinical medicine, dialysis-amyroidosis is well known to be one of the most common complications; this occurs when small molecular proteins, such as β 2 -microglobulin, are left unfiltered. [1][2][3][4] One of the undesirable phenomena that lead to a failure of hemodialysis is blood coagulation in the tubes. [5][6][7][8][9] This is caused mainly by the hemoagglutination activation protein.…”

mentioning

confidence: 99%

Analysis of Serum Proteins Adsorbed to a Hemodialysis Membrane of Hollowfiber Type by Thermal Lens Microscopy

et al. 1999

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To analyze serum proteins adsorbed to a hemodialysis membrane, immunostaining with colloidal gold and thermal-lens microscopy were employed. A total of 14 types of hemodialysis membranes were tested. The cross sections of the membranes were stained with fluorescent antibodies. Observations of these specimens using a laser microscope revealed that serum proteins, such as albumin and immuno globulins, tended to adsorb into the inner wall of these membranes. The degree of adsorption of serum proteins varied according to various conditions, such as what materials the membranes were made of or what proteins were adsorbed. For a better quantitative analysis of these proteins, the membranes were stained with immunogold and were observed by a thermal lens microscope. Colloidal gold coated with various antihuman serum proteins was used for the staining, and the quantity of colloidal gold was measured with a thermal-lens microscope. The quantity of colloidal gold, coated with anti-human sera antibody, gradiently decreased from the inner to the outer wall of the membrane. Probably, proteins with larger molecules were adsorbed to the inner parts, and those with smaller molecules were adsorbed to the outer parts of the membrane wall. High-resolution thermal-lens microscopy makes possible the sensitive detection of localized proteins adsorbed to a membrane without extracting it. Thus, the analysis of adsorbed proteins should serve to determine the adaptability of medical appliances to the human body and should also be helpful to a retrospective analysis of substances like drugs which are conjugated to the serum proteins.

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Carpal Tunnel Syndrome: a Major Complication in Hemodialysis Patients

Cited by 19 publications

References 9 publications

An Assessment of Symptomatic Relief after Carpal Tunnel Release in Patients on Haemodialysis

An Assessment of Symptomatic Relief after Carpal Tunnel Release in Patients on Haemodialysis

Does Carpal Tunnel Release Provide Long-Term Relief in Patients with Hemodialysis-Associated Carpal Tunnel Syndrome?

Analysis of Serum Proteins Adsorbed to a Hemodialysis Membrane of Hollowfiber Type by Thermal Lens Microscopy

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