Subacute Polyneuropathy after Initiation of Peritoneal Dialysis, Improved Following Kidney Transplantation

Uremic neuropathy is the most common neurologic complication of uremia, and it affects more than 60% of patients with end-stage renal disease (ESRD) who undergo dialysis. This type of neuropathy symmetrically involves the distal extremities, especially the lower limbs. On electrophysiological assessment, an axonal pattern is dominant. The clinical course and the intensity of uremic neuropathy vary from one individual to another. Coexisting chronic conditions such as diabetes mellitus can aggravate the symptoms, while dialysis can stop or delay progression of chronic uremic neuropathy. Complete improvement occurs after kidney transplantation. Recently, acute and subacute neuropathies in ESRD patients have also been reported. These conditions have a demyelinating feature and develop after the initiation of continuous ambulatory peritoneal dialysis (CAPD). The pathogenesis of these nonchronic forms of neuropathy remains unclear. We report 2 cases of subacute uremic polyneuropathy that improved following kidney transplantation.