Carpal tunnel syndrome in long-term hemodialyzed patients.

The etiopathology, clinical features, and treatment of carpal tunnel syndrome (CTS) in long-term hemodialyzed patients, are discussed in the light of new clinical findings. Conclusions summarizing the specific characteristics of CTS in hemodialyzed patients include the following. 1) There is a relatively equal sex ratio of patients. 2) The pathogenesis is complex and includes a) the presence of hemodynamic alterations related to the AV fistula; b) the presence of beta 2 M amyloid deposits related to biocompatibility of the dialysis membranes; and c) a correlation between CTS and the duration of hemodialysis related to years and hours/week. 3) A dramatic increase of CTS incidence occurs after five years of dialysis treatment. Prevention as a realistic goal in dialysis CTS is discussed, and specific recommendations are offered by the authors.