Advanced glycation end products and β(2)-microglobulin as predictors of carpal tunnel syndrome in hemodialysis patients.
OBJECTIVE
Carpal tunnel syndrome (CTS) is a common clinical presentation of dialysis-related amyloidosis. It was determined whether β(2)-microglobulin (β2M) and advanced glycation end products in serum are predictors of CTS in dialysis patients.


METHODS
A total of 385 hemodialysis patients were screened for CTS. β2M in serum was determined by a competitive enzyme-linked immunoassay, CML by a competitive enzyme-linked immunosorbent assay and total pentosidine by reverse-phase high-performance liquid chromatography.


RESULTS
127 patients (33%) were treated with biocompatible membranes, 174 (45%) with high-flux dialysis. 122 patients (31.7%) had clinical signs of CTS. Significant predictors of CTS were: age, female gender, serum β2M, total protein, dialysis with non-biocompatible high-flux dialysis compared to non-biocompatible low-flux dialysis, Kt/V and serum concentration of CML (OR 2.47 for the 3rd vs. 1st quartile, 95% CI 1.229-4.961, p = 0.011).


CONCLUSIONS
The prevalence of CTS as a possible manifestation of dialysis-related amyloidosis is still high. Serum concentration of CML may be a predictor of CTS besides β2M and malnutrition.
Department of Internal Medicine III, Jena University Hospital - Friedrich Schiller University, Jena, Germany. martin.busch@med.uni-jena.de
Martin
M
Busch
Andreas
A
Schwenzky
Sybille
S
Franke
Günter
G
Stein
Gunter
G
Wolf
D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D002349:Carpal Tunnel Syndrome / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D008239:Lysine / Q000031:analogs & derivatives / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects* / Q000295:instrumentation; D001613:beta 2-Microglobulin / Q000097:blood*
D017127:Glycation End Products, Advanced; D001613:beta 2-Microglobulin; D001120:Arginine; C062187:pentosidine; D008239:Lysine