Carpal Tunnel Syndrome in Patients on Intermittent Hemodialyis

Schiffl, Helmut

doi:10.1159/000343569

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…It has been proved by various clinical studies that parathyroid hormone (PTH) accumulation results in renal osteodystrophy and ectopic calcification, 1,2 the accumulation of beta microglobulin (b 2 -M) leads to amyloid change and carpal tunnel syndrome, 3,4 and the accumulation of cytokines, such as interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor (TNF-a) result in chronic systemic inflammation. [5][6][7][8] Many of these complications are irreversible by standard and conventional hemodialysis (HD) and pose a challenge to the long-term survival of patients on dialysis.…”

Section: Introductionmentioning

confidence: 99%

The optimal timing of hemoperfusion component in combined hemodialysis–hemoperfusion treatment for uremic toxins removal

et al. 2014

Renal Failure

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The combination of hemodialysis-hemoperfusion (HDHP) has been proved to be superior to hemodialysis (HD) in eliminating uremic toxins. There are two methods of combination of HD and HP: the HP regime is utilized during the first two-hour an early HP conducted HDHP (EHDHP) or the last two-hour late HP conducted HDHP (LHDHP) of 4 h regular HD session. The present study was to compare these two methods in uremic toxins removal. Twenty adult chronic HD patients were enrolled in this self-control method study. The patients were randomized to receive one session of EHDHP or LHDHP. Two weeks later, the dialysis modalities were switched. The reduction ratio (RR) of targeted uremic toxins for each session was assessed. Both EHDHP and LHDHP showed a significant removal of small water-soluble solutes, middle-sized toxins and cytokines as well (p50.05). There were no significant differences between two methods in RR of small water-soluble solutes, like urea and creatinine. For middle-sized molecules and cytokines, such as PTH, b 2 -M, IL-1, IL-6, and TNF-a, the RR was markedly increased in LHDHP than that in EHDHP (p50.05). LHDHP showed no more intradialytic events than EHDHP. The combination of HD and HP in the last two hours in one hemodialysis session had more effect on eliminating middle-sized toxins and cytokines.

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Section: Introductionmentioning

confidence: 99%

The optimal timing of hemoperfusion component in combined hemodialysis–hemoperfusion treatment for uremic toxins removal

et al. 2014

Renal Failure

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“…Carpal tunnel syndrome (CTS) is common among patients receiving hemodialysis and deeply influences their daily life [1–3]. Amyloid deposits are considered as the main reason for median nerve compression [4–6], and long-term HD therapy was found to cause a higher occurrence of CTS.…”

Section: Introductionmentioning

confidence: 99%

MRI analysis of carpal tunnel syndrome in hemodialysis patients versus non-hemodialysis patients: a multicenter case-control study

et al. 2019

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Background Carpal tunnel syndrome (CTS) is common among patients receiving hemodialysis and deeply influences their daily life. Amyloid deposits are considered the main reason for median nerve compression, but its prevalence is unclear. Therefore, to determine the main region of amyloid deposition inside the carpal tunnel, we measured the cross-sectional area (CSA) of each component of the carpal tunnel in preoperative magnetic resonance imaging (MRI). Methods Thirty-five hemodialysis patients (HD group) and age- and sex-matched 35 non-hemodialysis patients (non-HD group), who underwent the first surgery for CTS in registered hospitals from 2005 to 2015, were retrospectively enrolled. CTS was diagnosed from clinical and electromyographic (EMG) findings. The CSA of carpal tunnel, each of the flexor tendons, and the median nerve at the level of the hook of hamate were measured in T1-weighted axial images in preoperative MRI, by using Synapse OP-A software. Statistical analysis was performed using the Student’s t test and Pearson’s chi-squared test. Results The mean age of the HD group was 65.9 years and the dialysis duration was 21.9 (11–35) years. The mean age of the non-HD group was 65.3 years. The CSA of carpal tunnel ( p = 0.006), flexor tendon ( p = 0.03), and flexor digitorum profundus (FDP) tendon ( p = 0.04) were bigger in the HD group. However, the median nerve, the flexor digitorum superficialis (FDS) tendon, and the flexor pollicis longus tendon (FPL) were not significantly different between the two groups. The dialysis duration or age at surgery did not show any strong correlation to each CSA. Conclusions We confirmed that hemodialysis caused expansion of the carpal tunnel due to amyloid deposition as previously described. Hemodialysis also caused expansion of the CSA of the flexor tendon, especially the FDP, possibly because of amyloid deposition inside the tendon. Furthermore, the duration of dialysis or age did not correlate with any CSA, which could be due to the good progress of the beta 2-microglobulin removal technique. Based on our results, FDS excision could be considered in case severe deposition of amyloid in FDP is observed during surgery.

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The Role of Ultrasonographic Monitoring for Hip Joint Changes in Patients with Chronic Renal Failure

Matoković¹,

Hašpl²,

Petrić³

et al. 2011

Hemodialysis - Different Aspects

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Carpal Tunnel Syndrome in Patients on Intermittent Hemodialyis

Cited by 3 publications

References 12 publications

The optimal timing of hemoperfusion component in combined hemodialysis–hemoperfusion treatment for uremic toxins removal

The optimal timing of hemoperfusion component in combined hemodialysis–hemoperfusion treatment for uremic toxins removal

MRI analysis of carpal tunnel syndrome in hemodialysis patients versus non-hemodialysis patients: a multicenter case-control study

The Role of Ultrasonographic Monitoring for Hip Joint Changes in Patients with Chronic Renal Failure

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