Hemodialysis-related lesions of the hand

Rev Rhum Engl Ed. 1995 Apr;62(4):233-40.


Chronic hemodialysis patients often have lesions of the hands characterized by distinctive etiopathogenic mechanisms and functional consequences. We conducted a prospective cross-sectional study in 116 patients with a mean age of 55.9 years and a mean hemodialysis duration of 8.17 years. Carpal tunnel syndrome was present in 28.4% of patients. Median nerve entrapment was bilateral in a large proportion of cases. Wasting of the lateral thenar muscles was often present at diagnosis, denoting advanced nerve compression. Amyloid was demonstrated in the carpal tunnel in 74% of cases of carpal tunnel syndrome. Digital flexor tendon lesions responsible for trigger finger or restriction of active flexion were seen in 21.5% of patients. Erosive arthropathy manifesting as deformities, pain and loss of function affected the distal interphalangeal joints in 11% of patients and the proximal interphalangeal joints or trapeziometacarpal joint in a smaller proportion of patients. Thirty per cent of patients had bony cysts located in the carpometacarpal area, carpal bones, or distal forearm bones; communication with the adjacent joint space was seen occasionally, and intracarpal derangement was a feature in some patients. Most patients had several types of lesions. The rate of occurrence of hand lesions increased markedly after ten years on hemodialysis, with devastating functional consequences.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carpal Tunnel Syndrome / etiology*
  • Cross-Sectional Studies
  • Female
  • Hand*
  • Humans
  • Joint Diseases / etiology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Radiography
  • Renal Dialysis / adverse effects*
  • Tendons / physiopathology*
  • Wrist Injuries / diagnostic imaging