[Acute reversible carpal tunnel syndrome following arteriovenous fistula surgery].

We report a rare case of hand pain acutely experienced after arteriovenous placement with vascular derangement playing an etiopathogenetic key role and misleading neurological features due to a painless and misunderstood carpal tunnel syndrome. It cannot be explained by any well-defined pathophysiologic mechanism underlying the hand pain syndrome of hemodialysis patient. It is worth to note that the pain spontaneously relieved within few weeks in accordance with the time of transient tissue hypoxia triggered by fistula construction. In conclusion, an accurate neurological examination is mandatory in planning phase of vascular access, especially in the presence of special features or risk factors. Nevertheless, we would like to stress that the nephrologists must keep in mind that the wide range of ischemic damage caused by the arteriovenous fistula includes not only necrotic damage but also transient tissue hypoxia. The latter can spontaneously regress within few weeks, so that any deferrable decision must be postponed for at least thirty days.