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Brachial neuropathy after brachial artery-antecubital vein shunts for chronic hemodialysis

Departments of Neurology and Renal Medicine, Worcester Memorial Hospital, and the University of Massachusetts Medical School, Worcester, MA.

Peripheral mononeuropathies may complicate distal arteriovenous fistulas for chronic renal dialysis. We observed three diabetic patients who developed pain, paresthesias, and weakness in the distribution of the median, ulnar, and radial nerves shortly after construction of proximal brachial artery-antecubital vein fistulas. EMG confirmed multiple distal nerve injuries. All three patients improved after shunt banding or ligation. Twenty additional patients with proximal shunts were examined for risk factors for brachial neuropathy. Although all patients had severe atherosclerosis and many had polyneuropathy, we identified no predictive risk factors other than diabetes.

Address correspondence and reprint requests to Dr. Markley, Department of Neurology, Worcester Memorial Hospital, 119 Belmont Street, Worcester, MA 01605.

Presented in part at the thirty-seventh annual meeting of the American Academy of Neurology, Dallas, TX, April 1985.

Received June 30, 1986. Accepted for publication in final form December 12, 1986.

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