Progressive, predominantly motor, uraemic neuropathy

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Abstract
A severe, rapidly progressive neuropathy is described in 4 young male adults with end-stage renal failure, 3 of whom had accelerated hypertension. The onset of symptoms developed after regular hemodialysis had been started and in all 4 patients was closely associated with a septicemic illness. In 2 patients, renal transplantation led to considerable clinical improvement, and in a 3rd patient charcoal hemoperfusion halted further clinical progression of the neuropathy. This improvement was not reflected by the nerve conduction studies which remained grossly impaired. A possible ischemic etiology related to accelerated hypertension and septicemia is suggested for this unusual variant of uremic neuropathy.