Carpal tunnel syndrome: a major complication in hemodialysis patients

In order to assess the prevalence of the carpal tunnel syndrome (CTS) suggestive of beta 2 microglobulin amyloid deposit in patients undergoing hemodialysis with cuprophan and acetate membrane, we studied 30 patients who had been receiving hemodialysis for varying lengths of time. Besides a standard physical and rheumatological examination, nerve conduction velocity studies were done in median and ulnar motorsensory nerves. 12 patients had normal findings, 12 had CTS (9 pure CTS, 3 with neuropathy), and 9 had peripheral neuropathy. Nerve dysfunction was independent of the disease underlying renal failure, the side of the dialysis access shunt and factors such as age and sex. We suggest that hemodialysis patients need frequent EMG analysis to identify CTS early and to avoid irreversible nerve damage.