To the Editor.— The recent article by Jain et al (242:2868, 1979), "Carpal Tunnel Syndrome in Patients Undergoing Maintenance Hemodialysis," prompts the following observations. Although distal motor latency (DML) was measured in median and ulnar nerves, the distal sensory latency (DSL) in these nerves was either not performed or not recorded. Since the median nerve DSL is known to be a far more sensitive indicator of carpal tunnel syndrome than the DML,1the reported incidence of the syndrome (ten of 62 hemodialysis patients) is probably a spuriously low one. Carpal tunnel syndrome is more frequently encountered in patients with systemic conditions associated with peripheral polyneuropathy such as diabetes mellitus and rheumatoid arthritis. Also among these are acute and chronic renal failure.2Perhaps the carpal tunnel syndrome found in all these systemic conditions can be partly ascribed to heightened sensitivity of a neuropathic median nerve to relatively minor degrees