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Sonographic examination of the median nerve in dialysis patients and after renal transplantation

OBJECTIVE: Patients with renal insufficiency are predisposed to develop CTS (carpal tunnel syndrome). In particular, long‐term dialysis seems to contribute to changes in median nerve texture which lead to an increased risk for CTS. The current study was designed to evaluate if these structural chang...

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Autores principales: Carolus, Anne Elisabeth, Schenker, Peter, Dombert, Thomas, Fontana, Johann, Viebahn, Richard, Schmieder, Kirsten, Brenke, Christopher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714645/
https://www.ncbi.nlm.nih.gov/pubmed/26807335
http://dx.doi.org/10.1002/brb3.406
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author Carolus, Anne Elisabeth
Schenker, Peter
Dombert, Thomas
Fontana, Johann
Viebahn, Richard
Schmieder, Kirsten
Brenke, Christopher
author_facet Carolus, Anne Elisabeth
Schenker, Peter
Dombert, Thomas
Fontana, Johann
Viebahn, Richard
Schmieder, Kirsten
Brenke, Christopher
author_sort Carolus, Anne Elisabeth
collection PubMed
description OBJECTIVE: Patients with renal insufficiency are predisposed to develop CTS (carpal tunnel syndrome). In particular, long‐term dialysis seems to contribute to changes in median nerve texture which lead to an increased risk for CTS. The current study was designed to evaluate if these structural changes can be detected by HRS (high‐resolution sonography). Additionally, the current study aimed to determine if changes are reversible after termination of dialysis. METHODS: Fifty patients (98 hands) were included in the study. The study population was subdivided into three groups: patients without any history of renal disease (H, n = 20), patients with long‐term dialysis (D, n = 10), and patients after renal transplantation (TX, n = 20). None of the patients had any clinical symptoms for a median nerve compression syndrome. The CSA (cross‐sectional area) of the median nerve was evaluated both 12 cm proximally of the carpal tunnel inlet and directly at the carpal tunnel inlet. The ratio of those two values, the WFR (wrist forearm ratio), was calculated and analyzed. RESULTS: The CSA demonstrated significantly higher values in dialysis (D) and transplanted (TX) patients compared to the healthy (H) control group (P < 0.001). No significant differences were detectable between the D and TX groups. Specifically, there was no significant difference in the WFR. CONCLUSION: Patients with chronic renal disease demonstrate significantly higher CSA values compared to their healthy counterparts. Termination of dialysis does not seem to reverse these morphological changes.
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spelling pubmed-47146452016-01-22 Sonographic examination of the median nerve in dialysis patients and after renal transplantation Carolus, Anne Elisabeth Schenker, Peter Dombert, Thomas Fontana, Johann Viebahn, Richard Schmieder, Kirsten Brenke, Christopher Brain Behav Original Research OBJECTIVE: Patients with renal insufficiency are predisposed to develop CTS (carpal tunnel syndrome). In particular, long‐term dialysis seems to contribute to changes in median nerve texture which lead to an increased risk for CTS. The current study was designed to evaluate if these structural changes can be detected by HRS (high‐resolution sonography). Additionally, the current study aimed to determine if changes are reversible after termination of dialysis. METHODS: Fifty patients (98 hands) were included in the study. The study population was subdivided into three groups: patients without any history of renal disease (H, n = 20), patients with long‐term dialysis (D, n = 10), and patients after renal transplantation (TX, n = 20). None of the patients had any clinical symptoms for a median nerve compression syndrome. The CSA (cross‐sectional area) of the median nerve was evaluated both 12 cm proximally of the carpal tunnel inlet and directly at the carpal tunnel inlet. The ratio of those two values, the WFR (wrist forearm ratio), was calculated and analyzed. RESULTS: The CSA demonstrated significantly higher values in dialysis (D) and transplanted (TX) patients compared to the healthy (H) control group (P < 0.001). No significant differences were detectable between the D and TX groups. Specifically, there was no significant difference in the WFR. CONCLUSION: Patients with chronic renal disease demonstrate significantly higher CSA values compared to their healthy counterparts. Termination of dialysis does not seem to reverse these morphological changes. John Wiley and Sons Inc. 2015-11-14 /pmc/articles/PMC4714645/ /pubmed/26807335 http://dx.doi.org/10.1002/brb3.406 Text en © 2015 The Authors. Brain and Behavior published by Wiley Periodicals, Inc. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Carolus, Anne Elisabeth
Schenker, Peter
Dombert, Thomas
Fontana, Johann
Viebahn, Richard
Schmieder, Kirsten
Brenke, Christopher
Sonographic examination of the median nerve in dialysis patients and after renal transplantation
title Sonographic examination of the median nerve in dialysis patients and after renal transplantation
title_full Sonographic examination of the median nerve in dialysis patients and after renal transplantation
title_fullStr Sonographic examination of the median nerve in dialysis patients and after renal transplantation
title_full_unstemmed Sonographic examination of the median nerve in dialysis patients and after renal transplantation
title_short Sonographic examination of the median nerve in dialysis patients and after renal transplantation
title_sort sonographic examination of the median nerve in dialysis patients and after renal transplantation
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714645/
https://www.ncbi.nlm.nih.gov/pubmed/26807335
http://dx.doi.org/10.1002/brb3.406
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