The effect of arteriovenous fistula and its site on the incidence of Carpal tunnel syndrome in hemodialysis patients

One of the main complications associated with arteriovenous fistula in hemodialysis patients is the median nerve ischemic neuropathy in the wrist. This study was conducted to examine the effect of arteriovenous fistula on the development of carpal tunnel syndrome. This cross-sectional study was conducted on 37 hemodialysis patients at Shahid Mohammadi Hospital of Bandar Abbas in 2007-2008. All of the patients had either a distal or a proximal arteriovenous fistula in one hand. Nerve conduction velocity and median nerve distal sensory and motor latency were applied to the diagnosis of carpal tunnel syndrome. The limb with fistula (the case) was compared to the one without it. Data were analyzed through independent t-test and Pearson product correlation. Overall, 17 patients had proximal and the rest had distal fistulas. Fistulas aging more than one year were seen in 15 patients and 22 patients had fistulas less than one year old. Carpal tunnel syndrome had developed in 25 wrists with fistula (17 motor and 8 sensory cases) and 27 wrists without fistula. A significant difference was observed in the median nerve distal sensory latency between the wrists with fistula and those without it. There was not a significant difference between the variables. In addition, there was a significant difference between the age of the fistulas and the incidence of carpal tunnel syndrome. The rate of the development of carpal tunnel syndrome in wrists with or without fistula is the same. Also, the site of the fistula does not have any effects on the incidence of the median nerve ischemic neuropathy.