Why does Carpal Tunnel Syndrome Still Occur in our Chronic Hemodialysis Patients? Intissar Haddiya 1* , Hicham Yacoubi 2 and Yassamine Bentata 1 1 Department of Nephrology, Dialysis and Renal Transplantation, Mohamed VI University Hospital, University Mohamed First, Oujda, Morocco 2 Department of Orthopaedics, Mohamed VI University Hospital, University Mohamed First, Oujda, Morocco * Corresponding author: Intissar Haddiya, Faculty of Medicine, Department of Nephrology, Dialysis and Renal Transplantation, Mohamed VI University Hospital, University Mohamed First, Oujda, Morocco, Tel: +00212661281400; E-mail: intissarhaddiya@yahoo.fr Received Date: May 09, 2018; Accepted Date: May 17, 2018; Published Date: May 21, 2018 Copyright: © 2018 Haddiya I, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Despite the numerous advances in hemodialysis practice, cases of CTS are still observed in our patients. The aim of this study was to assess the prevalence of CTS and factors associated to its occurrence in our chronic HD patients. Methods: We performed a cross-sectional study in December 2017, including consenting chronic hemodialysis patients, with a dialysis vintage of at least three months, in a reference state center in Oujda- Eastern Morocco. Diagnosis was based on signs and symptoms reported by the patient, and manoeuvres of Tinel and Phalen. Symptomatic patients underwent electromyography (EMG) on non-dialysis days, by the same neurologist in the same conditions. Results: Our study included 112 chronic HD patients, who met the inclusion criteria. CTS was diagnosed and verified using nerve conduction examination in 8.04% of the patients. Diabetic nephropathy was the most observed initial nephropathy in CTS patients in 36.3% of the cases. Patients with CTS were older (mean age: 52.99 ± 11.32 vs. 48.4 ± 12.6; p=0.002), mainly males (63.6% vs. 55.4%; p=0.03), active smokers in 18.5% of the cases. They also had a longer HD duration (95.8 ± 15.75 vs. 82.11 ± 17.22 months; P<0.001). Moreover, CTS patients had higher diabetes mellitus prevalence (36.3% vs. 13.8%; p<0.001), higher HCV prevalence (18.18% vs. 2.97%; p=0.02), and were less likely to have a urine output >100 ml/day (27.2% vs. 3.98%; P=0.003). Multivariate logistic regression showed that HCV (OR: 1.45, 95% confidence interval (CI): 1.17-1.87, p=0.034), HD vintage [OR: 1.95, 95% CI: 1.89-3.65, P<0.001] and urin output <100ml/day (OR:1.72, 95% CI: 1.03-2.57, P=0.01) were positively associated with CTS. Conclusion: In this cross-sectional study, we observed that a long dialysis vintage, positive HCV and loss of residual renal function were associated with CTS in chronic HD patients. However, additional studies are required for further clarification of the pathogenesis of CTS in chronic HD patients. Keywords: Carpal Tunnel syndrome; Hemodialysis; Renal disease; Kidney disease Introduction Carpal tunnel syndrome (CTS) is a well-known manifestation of dialysis related amyloidosis, mainly caused by the deposition of β2- microglobulin in the carpal tunnel. It is considered as the most common mononeuropathy in endstage renal disease (ESRD) patients [1,2]. A long duration of hemodialysis (HD) as well as increased plasma beta-2-microglobulin (BMG) are believed to play an important role in its development in HD patients [3]. Nevertheless, the exact causes leading to CTS occurrence remain unclear. Diagnosis is based on both clinical signs and nerve conduction fndings. Dialysis improvement and renal transplantation represent the best prevention while surgery remains the most performed curative treatment [4]. Although our hemodialysis practice has witnessed big advances with the use of high effciency biocompatible membranes and a high water quality, cases of CTS are still observed in our patients. Te aim of this study was to assess the prevalence of CTS and factors associated to its occurrence in our chronic HD patients. Patients and Methods We performed a cross-sectional study in December 2017, including consenting chronic hemodialysis patients, with a dialysis vintage of at least three months, in a reference state center in Oujda Eastern Morocco. Diagnosis was based on signs and symptoms reported by the patient such as paresthesia and pain in the median nerve territory. Manoeuvres of Tinel and Phalen were used on both hands and were considered positive if they reproduced spontaneous pain or paresthesia in the thumb, forefnger and middle fnger, which represent the territory of the median nerve. A sensory defcit in the median nerve territory as well as amyotrophy of external thenars were noted. Demographic and biology data were collected from patients medical records. Te latter included-reactive protein (CRP), intact parathyroid hormone (PTH 1-84). J o u r n a l o f N e p h r o l o g y & T h e r a p e u t i c s ISSN: 2161-0959 Journal of Nephrology & Therapeutics Haddiya et al., J Nephrol Ther 2018, 8:3 DOI: 10.4172/2161-0959.1000310 Research Article Open Access J Nephrol Ter, an open access journal ISSN: 2161-0959 Volume 8 • Issue 3 • 1000310