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

Abstract

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.

Arm and hand function in hemodialysis patients. A cross sectional analytical study

“…We also have found that pain and paresthesia, Paresthesias, the hallmark of neuronal involvement, may be caused by carpal tunnel involvement [14], nerve hypoxia due to ischemia by the A-V fistula [6] or by uremic neuropathy [15,16]. According to the literature carpal nerve syndrome is seen in 2% to 30% of patients [17,18] and may be due to limb edema caused by the A-V fistula or to deposition of Beta 2 amyloid [19].…”

Association between low serum prealbumin levels and carpal tunnel syndrome in maintenance hemodialysis patients

“…CTS affects 30-50% patients who have been on hemodialysis for over 10 years and over 80% patients who have been on hemodialysis for over 30 years. Specific factors contribute to the development of carpal tunnel syndrome in patients on chronic hemodialysis, including b2-microglobulin (b2-M) fiber deposits and arteriovenous (AV) fistula [5][6][7][8]. Malnutrition-inflammation-atherosclerosis syndrome is a common cause of increased mortality in chronic kidney disease [9][10][11].…”

<p>Ultrasound-guided percutaneous carpal tunnel release in patients on hemodialysis: early experiences and clinical outcomes</p>

“…Carpal tunnel syndrome (CTS) is a frequent complication of patients undergoing hemodialysis. It often causes pain, numbness, tingling, or burning sensation in the median nerve distribution, hand weakness, and reduced quality of life 1,2,3. CTS in hemodialysis patients is recognized as an unremitting course, and surgical release procedures are often required after a long period of hemodialysis 4,5…”