Shear Wave Velocity Measurements of the Median Nerve in Patients on Chronic Hemodialysis

Abstract

Objectives Chronic dialysis causes changes in the structure of median nerve. This is a risk for the development of carpal tunnel syndrome in patients on dialysis. The aim of the present study was to evaluate the diagnostic capacity of shear wave velocity (SWV) and the cross-sectional area (CSA) to detect the structural changes of the median nerve in patients with end-stage chronic kidney disease on hemodialysis.

Methods Twenty-five patients with chronic kidney disease undergoing hemodialysis 3 times per week and 26 healthy controls were included. None of the participants had any signs or symptoms of carpal tunnel syndrome specified according to the criteria of the American Academy of Neurology Practice Parameters. Both patients and controls underwent sonographic and elastographic examinations of the median nerves in both hands to evaluate CSA and SWV values, and they were compared regarding these parameters.

Results The mean CSA of the median nerve in the chronic hemodialysis group was significantly higher than that in the control group (12.74 +/- 1.88 mm(2) versus 8.89 +/- 1.45 mm(2); P < .001). The mean longitudinal and axial SWV values in the hemodialysis group (3.86 +/- 0.54 m/s and 3.92 +/- 0.52 m/s, respectively) were significantly higher than those in the control group (2.98 +/- 0.31 m/s and 3.04 +/- 0.31 m/s, respectively; P < .001).

Conclusions Patients on chronic hemodialysis had higher mean CSA and SWV values of the median nerve compared with the healthy controls. Structural changes in the median nerve that occur in patients on chronic hemodialysis can be detected by shear-wave sonoelastogr