Cardiac Troponin T and Cardiac Troponin I Levels in End Stage Renal Disease Patients Undergoing Hemodialysis : as Markers of Myocardial Injury / 대한신장학회잡지

BACKGROUND: The main cause of death in maintenance hemodialyzed patients is cardiovascular event. Serum cardiac troponin T(cTnT) and I(cTnI) are increased in the serum of patients with chronic renal failure. METHODS: We studied the incidence of increased serum cTnT and cTnI, the differences of their positivity, and the myocardial injury and cardiovascular risk factors in 56 maintenance hemodialyzed patients (30 males, 26 females). We investigated the patients about smoking, diabetes, hypertension and anginal pain. Blood was obtained from the patients immediately before hemodialysis. Samples were analyzed for myoglobin, CPK, LDH, total cholesterol, hemoglobin, PTH, cTnT and cTnI. Also, we evaluated the duration and adequacy(Kt/V(urea)) of dialysis and ECG. cTnT was measured by ECLIA(reference value

Carpal Tunnel Syndrome in Chronic Renal Failure Patients Undergoing Continuous Ambulatory Peritoneal Dialysis(CAPD) / 대한신장학회잡지

BACKGROUND: Carpal tunnel syndrome(CTS) is a long-term complication in dialysis patients which results from compression of the median nerve within the carpal tunnel. It has been reported to occur with increased frequency in the hemodialysis population, but, there are few reports concering long-term complications in CAPD because of the relatively shorter duration of dialysis in most CAPD patients. The aim of this study was to determine the incidence of CTS in patients undergoing CAPD. METHODS: We analyzed 21 chronic renal failure (CRF) patients(males 14, females 7; age range 19-79 yr) undergoing CAPD. The patients were evaluated by questionnare, physical examination, and nerve conduction test(NCT). Age, gender, duration of CRF before CAPD, duration of CAPD, diabetic history were determined. RESULTS: Among the total 21 patients undergoing CAPD, only 5 patients(24%) were CTS, diagnosed by NCT. Two of these patients were symptomatic CTS, three patients were non-symptomtic CTS. So, there were no relationship between the incidence of CTS and clinical symptoms. Among the diabetic dialysis patients, the incidence of CTS was 28.57%. Also there was no increase in the number of diatetic patients with CTS. CONCLUSION: It is concluded that the incidence of CTS in CAPD patients was similar with the previous reported incidence(2-31%) of hemodialysis patients. Since CTS is treatable, annual or even semiannual nerve conduction tests is indicated all CRF patients on chronic dialysis.

Carpal Tunnel Syndrome in Hemodialysis Patients of Chronic Renal Failure / 대한신장학회잡지

OBJECTIVE: Carpal tunnel syndrome(CTS) is one of the compression neuropathy in long-term hemodialysis patients, that considerably caused by venous stasis or edema in the site of the vascular access, arterial steal syndrome and currently reported, amyloid deposit. CTS shows pain, paresthesia and weakness in the area that median nerve is distributed. We analysed the incidence and characteristics of nerve conduction test of CTS in the patients of hemodialyzed chronic renal failure. METHODS: Thirty hemodialyzed patients were enrolled and divided three groups in peripheral polyneuropathy(PNP) only, CTS only, and both by clinical manifestations and results of nerve conduction test. RESULTS: 1) In all thirty patients, two(7%) had a CTS only, seven(23%) had a PNP only and sixteen(54%) had combined PNP with CTS. 2) In al thirty patients(60 hands), 2 cases(two-3%) had a CTS with clinical manifestations, 25 cases (siteen-42%) had a CTS without clinical manifestation and 1 case(one-1.7%) showed clinical manifestations of CTS but was not diagnosed CTS by nerve conduction test. There was no significant correlation between clinical manifestations and development of CTS(p>0.05). 3) In all thirty patients(60 hands), 6 cases(four-10 %) had a CTS with edema, 21 cases(fourteen-35%) had a CTS without edema and 2 cases(two-1.7%) showed edema of hands but was not diagnosed CTS by nerve conduction test. There was no significant correlation between edema and development of CTS (p>0.05). 4) Among the eighteen patients with CTS, nine (50%) patients were involved in one hand, nine(50%) patients in both. 5) In the sixty hands, 33 hands had vascular access, in which 13 cases(39.4%) had CTS and 20 cases(60.6%) had not. In the 27 hands which had not vascular access, 14 cases(51.6%) had CTS and 13 cases(48.1%) had not. There was no significant correlation between vascular access and development of CTS(p>0.05). CONCLUSION: The incidence of CTS in the patients of hemodialyzed chronic renal failure was 60%. There was no significant correlation between CTS and vascular access, edema, duration of hemodialysis. Subclinical CTS was more frequent compared to the overt CTS.