Korean Journal of Nephrology 2000;19(6):1115-1120.

혈액투석 중인 말기신부전 환자들에서의 수근관증후군 (Carpal Tunnel Syndrome in Hemodialysis Patients of Chronic Renal Failure)

김양욱(Yang Wook Kim),윤혁진(Hyuk Jin Yoon),김영훈(Young Hoon Kim),김현동(Hyun Dong Kim),박인선(In Sun Park)

Abstract

Objective: Carpal tunnel syndrome(CTS) is one of the compression neuropathy in long-term hemodialysis patients, that considerably caused by venous stasis or edema in the site of the vascular access, arterial steal syndrome and currently reported, amyloid deposit. CTS shows pain, paresthesia and weakness in the area that median nerve is distributed. We analysed the incidence and characteristics of nerve conduction test of CTS in the patients of hemodialyzed chronic renal failure. Methods: Thirty hemodialyzed patients were enrolled and divided three groups in peripheral polyneuropathy(PNP) only, CTS only, and both by clinical manifestations and results of nerve conduction test. Results: 1) In all thirty patients, two(7%) had a CTS only, seven(23%) had a PNP only and sixteen(54%) had combined PNP with CTS. 2) In al thirty patients(60 hands), 2 cases(two-3%) had a CTS with clinical manifestations, 25 cases (siteen-42%) had a CTS without clinical manifestation and 1 case(one-1.7%) showed clinical manifestations of CTS but was not diagnosed CTS by nerve conduction test. There was no significant correlation between clinical manifestations and development of CTS(p>0.05). 3) In all thirty patients(60 hands), 6 cases(four-10%) had a CTS with edema, 21 cases(fourteen-35%) had a CTS without edema and 2 cases(two-1.7%) showed edema of hands but was not diagnosed CTS by nerve conduction test. There was no significant correlation between edema and development of CTS (p>0.05). 4) Among the eighteen patients with CTS, nine (50%) patients were involved in one hand, nine(50%) patients in both. 5) In the sixty hands, 33 hands had vascular access, in which 13 cases(39.4%) had CTS and 20 cases(60.6%) had not. In the 27 hands which had not vascular access, 14 cases(51.6%) had CTS and 13 cases(48.1%) had not. There was no significant correlation between vascular access and developrnent of CTS(p>0.05). Conclusion: The incidence of CTS in the patients of hemodialyzed chronic renal failure was 60%. There was no significant correlation between CTS and vascular access, edema, duration of hemodialysis. Subclinical CTS was more frequent compared to the overt CTS.