Examination of individual sural nerve fibres revealed segmental demyelination, in 10 out of 12 subjects with uraemia. Peripheral neuropathy was present in only two cases. The complex biochemical changes occurring with dialysis unmask the underlying demyelination in subjects with a latent neuropathy. This would explain the precipitation of a neuropathy in those subjects submitted for repeated dialysis. The possible correlation between creatinine retention, dialysis, and metabolic dysfunction in the Schwann cell system is discussed.
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