The Journal of Bone and Joint Surgery, Vol 70, Issue 8 1145-1153, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc
Carpal tunnel syndrome in patients who are receiving long-term renal hemodialysis
MS Gilbert, A Robinson, A Baez, S Gupta, S Glabman and M Haimov
Queens Artificial Kidney Center, Department of Orthopedic Surgery, Mount Sinai Hospital, New York City, New York 10128.
In forty-six (9 per cent) of 485 patients who were receiving long-term
renal hemodialysis, a carpal tunnel syndrome developed in at least one
hand. A total of sixty-four surgical procedures were performed for this
problem in forty-one patients. All of the forty-one patients reported
symptomatic relief, although three had recurrent symptoms. There was no
correlation between the time of onset of the carpal tunnel syndrome and
such factors as the patient's age, sex, or race; the cause of renal
failure; the site of vascular access for hemodialysis; or a history of
parathyroidectomy. There was a correlation, however, between the
development of the carpal tunnel syndrome, the side of the longest
functional vascular access, and the presence of arterial calcifications. In
all eleven patients in whom a radial steal syndrome developed, an
ipsilateral carpal-tunnel syndrome also developed. It was concluded that
factors other than those involving the site of vascular access must have
important etiological roles.