Screening for carpal tunnel syndrome in patients on chronic hemodialysis

Cilj: Ispitati prevalenciju rizika za sindrom karpalnog tunela u bolesnika na kroničnoj hemodijalizi (HD) pomoću Levineovog upitnika i ispitati odnos ovako određenog rizika s demografskim, antropometrijskim i laboratorijskim podacima. Nacrt studije: Presječna studija. Ispitanici i metode: U istraživanje je uključeno 78 bolesnika na kroničnoj HD na Zavodu za nefrologiju KBCO-a. Svi ispitanici su riješili probirni Levineov upitnik za sindrom karpalnog tunela. Demografski, antropometrijski i laboratorijski podaci ispitanika preuzeti su iz medicinske dokumentacije i statistički obrađeni u SPSS for Windows (inačica 16.0, SPSS Inc., Chicago, IL, SAD). Rezultati: U 38,5 % ispitanika nađen je rizik za sindrom karpalnog tunela. Između rizične skupine i skupine bez simptoma nije bilo značajne razlike u spolnoj raspodjeli, osnovnoj bubrežnoj bolesti i krvožilnom pristupu. Ispitanici u rizičnoj skupini bili su stariji (Mann Whitneyev U test, P = 0,044) i većeg indeksa tjelesne mase (ITM), (t-test, P = 0,019). Dob, ITM i prijedijalizna serumska koncentracija uree ispitanika nađeni su nezavisnim predskazateljima za rizik za sindrom karpalnog tunela. Zaključak: Prevalencija rizika za sindrom karpalnog tunela na kroničnoj HD je nađena u više od trećine bolesnika. Visoka životna dob, povećani ITM i prijedijalizna serumska koncentracija uree nose veći rizik. Elektromioneurografija je u ovoj populaciji bolesnika tako često indicirana, odnosno u svih s nađenim rizikom, a radi potvrde dijagnoze i posljedičnog kirurškog liječenja.Objectives: To determine the prevalence of carpal tunnel syndrome risk in patients on chronic hemodialysis (HD) using Levine questionnaire for assessment of carpal tunnel syndrome - related symptoms severity and patients' functional status and to examine the relation of the determined risk with the participants' demographic, anthropometric and laboratory data. Study Design: Cross-sectional study. Participants and Methods: Study included 78 chronic HD patients at Department for Nephrology in University Hospital Osijek. All the participants filled out the Levine questionnaire to examine the severity of carpal tunnel syndrome - related symptoms and their functional state. The participants' demographic, anthropometric and laboratory data were taken from the medical records and statistically analyzed by SPSS for Windows (version 16.0, SPSS Inc., Chicago, IL, SAD). Results: Risk for carpal tunnel syndrome was found in 38.5 % of participants. No significant differences between the symptomatic and asymptomatic group were found in sex distribution, underlying kidney disease or vascular access. Symptomatic participants were older (Mann Whitney U test, P = 0.044) and had higher body mass index (BMI), (t-test, P = 0.019). Participants' age, BMI and predialytic serum urea concentration are independent predictors for carpal tunnel syndrome risk. Conclusion: The prevalence of risk for carpal tunnel syndrome among patients on chronic HD was found in more than one third of patients. Older age, higher BMI and higher predialytic serum urea concentration bear a higher risk. Electromyoneurography is thus often indicated in this population to confirm the diagnosis for consecutive surgical treatment