A Possible Involvement of the Carboxymethylation Process in Carpal Tunnel Syndrome in Hemodialysis Patients

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A median motor nerve latency (DML) is generally prolonged in the carpal tunnel syndrome (CTS) of hemodialysis patients. Meanwhile, the advanced glycation process of proteins has been reported to be involved in the pathogenesis of the dialysis related amyloidosis. To investigate the role of carboxymethylation in dialysis related CTS, we measured a circulating carboxymethyllysine-hemoglobin (CML-Hb) level and nerve conduction velocity in 44 hemodialysis patients. The circulating CML-Hb level was 6.56 ± 3.18 nmol CML/mg Hb, median motor nerve conduction velocity (NCV) was 49.8 ± 4.64 m/s, median DML was 4.44 ± 1.06 ms, and difference between median DML and ulnar DML (Δ DML) was 1.68 ± 1.09 ms. Median and ulnar nerve NCV showed no correlation with circulating CML-Hb level. Both median DML and Δ DML were significantly correlated with CML-Hb (r = 0.429, P = 0.003, r = 0.472, P = 0.001). This study provided additional clinical evidence of an involvement of an advanced glycation process in the pathogenesis in CTS in hemodialysis patients.

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