Introduction: Carpal tunnel syndrome (CTS) occurs as one of clinical features of Dialysis Related Amyloidosis (DRA). Recently, it has been suggested that advanced glycation endproducts (AGEs) and bate 2 microglobulin (b2m) modified with AGEs are related to DRA. In our previous cross-sectional study, the fact that serum pentosidine, which is an AGE, was higher in DRA than in non-DRA indicates that it has potential as an indicator for the occurrence of DRA in HD patients.

Aim: In this prospective study we examined to elucidate whether serum levels of pentosidine relate to the occurrence of CTS in patients with HD in 4 years longitudinal follow up.

Material and Methods: The subjects are 106 end-stage renal failure patients undergoing HD, who had never operated for CTS. Serum pentosidine was measured by the HPLC method with column switching. b2m and intact PTH were also measured. During follow up period we operated 15 patients for CTS.

Results: Pentosidine levels were significantly elevated in the operated group than the non-operated group, whereas there were not significant differences in b2m and intact-PTH.

Conclusion: These results indicate that serum pentosidine has the potential as an indicator for the occurrence of CTS in long-term hemodialysis patients.

Aim: Urinary C-terminal telopeptide of type I collagen (u-CTx) has been reported to be a sensitive biochemical marker of bone turnover. There have been two assays for urinary CTx, which are u-aCTx and u-BCTx. A newly developed immunoassay for serum CTx (s-CTx) is now available for assessment of bone resorption. We have both evaluated the effects of menopause, and osteoporosis on the measurements of serum CTx and compared them to urinary CTx assays.

Subjects: 79 premenopausal healthy women, 80 post-menopausal healthy women, 61 osteoporotic patients with vertebral fractures and 34 osteoporotic patients with hip fractures

Results: Bone resorption markers were increased after menopause. There was no significant difference among s-CTx, u-aCTx and u-BCTx in the T-scores of post-menopausal group over premenopausal group (T -score; s-CTx:2.3, u-aCTx:1.8, u-BCTx:2.1). Patients with vertebral fractures and patients with hip fracture had elevated levels of bone resorption markers compared to age-matched healthy postmenopousal women. There was no significant difference among s-CTx, u-aCTx and u-BCTx in the T-scores against postmenopausal group in vertebral fracture group (T -score; s-CTx:0.8, u-aCTx:0.9, u-BCTx:0.7) and in hip fracture group women (T-score; s-CTx:1.1, u-aCTx: 1.3 u-BCTx: 1.3).

Conclusions: These findings indicate that s-CTx reflects the increase of bone resorption associated with menopause and osteoporosis with vertebral fractures and hip fractures.