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Abstract: FR-PO749

The Swelling of the Median Nerve Is the Independent Risk Factor for Carpal Tunnel Syndrome in Patients with Short-Term Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kim, June hyun, Pusan National University Yangsan Hospital, Yangsan, Korea (the Republic of)
  • Lee, Soo Bong, Pusan National University Yangsan Hospital, Yangsan, Korea (the Republic of)
  • Kim, Il Young, Pusan National University Yangsan Hospital, Yangsan, Korea (the Republic of)
  • Lee, Dong Won, Pusan National University Yangsan Hospital, Yangsan, Korea (the Republic of)
  • Song, Sang Heon, Pusan National University Hospital, Busan, BUSAN, Korea (the Republic of)
  • Rhee, Harin, Pusan National University Hospital, Busan, BUSAN, Korea (the Republic of)
  • Han, Miyeun, Pusan National University Hospital, Busan, BUSAN, Korea (the Republic of)
Background

A carpal tunnel syndrome (CTS) is a frequent complication of long-term hemodialysis. 20% to 50% of the patients dialyzed for 10 years or longer are reported to have CTS. However, risk factors for CTS in short-term hemodialysis have been less known. In this study, we investigated whether the swelling of median nerve could be a risk factor for CTS in patients with relatively short-term hemodialysis (mean duration of hemodialysis: 4.03 years).

Methods

The study included 43 patients (23 male & 20 female) on maintenance hemodialysis and 97 healthy controls. We diagnosed the CTS by nerve conduction study (NCS) and clinical symptom. The cross-sectional area (CSA) of median nerve was measured at the wrist (CSA–W) and forearm (CSA-F) by ultrasonography. The wrist to forearm ratio (WFR; CSA-W/CSA-F) was calculated for each arm. The degree of swelling of median nerve was assessed by the WFR.

Results

The mean duration of hemodialysis (n=43) was 4.02 ± 3.30 years. The WFRs in hemodialysis patients were higher than those in healthy controls (1.37 ± 0.45 vs. 1.21 ± 0.25, P = 0.021). We classified into patients with CTS (n=19) and without CTS (n=24). There were no significant differences in age, sex, duration of hemodialysis, the cause of renal failure, β2-microglobulin, and adequacy of dialysis (Kt/V) between patients with CTS and without CTS. The WFRs in patients with CTS were higher than those in patients without CTS (1.5 ± 0.5 vs. 1.2 ± 0.2, P = 0.001). We performed ROC analysis to investigate the best cut-off value of WFR for predicting the CTS in all study subjects (n=43). The AUC of the WFR was 0.825 (95% CI: 0.678-0.923). The best cut-off value of the WFR was > 1.25 with a sensitivity of 84.2% and specificity of 70.8%. In multivariate analysis, the patients with WFR > 1.25 were 6.3 times more likely to have the CTS compared with patients WFR (HR: 6.30, 95% CI: 1.45-27.5, P = 0.014)

Conclusion

This study demonstrated that the swelling of median nerve was the independent risk factor for the CTS in patients with relatively short-term hemodialysis.