Peripheral Nerve Entrapment Syndromes in Chronic Hemodialysis Patients

Abstract

15 of 271 patients (6%) treated with chronic hemodialysis developed peripheral nerve entrapment syndrome of the median or the ulnar nerve. The majority of these patients were female (p < 0.03). Fistulas located in arms with nerve entrapment tended to have higher flow rates than fistulas located in arms without nerve entrapment (57% vs. 4.4%, p < 0.001). There was no correlation with the renal diagnosis, previous access surgery in the involved arm, the type of vascular access used, the duration of hemodialysis, the adequacy of dialysis, calcium or phosphate homeostasis, plasma parathyroid levels, or thyroid function. Surgical intervention successfully relieved all symptoms. Return of normal renal function does not reverse this disorder. Peripheral nerve entrapment is a common surgically correctable cause of neuropathy of the upper extremities in hemodialysis patients.