1. Date of download: 6/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin Denervation and Its Clinical Significance in Late-Stage Chronic Kidney Disease Arch Neurol. 2011;68(2):200-206. doi:10.1001/archneurol.2010.372 Skin innervation in uremia. The skin biopsy specimens from a control (A, C, and E) and a patient with uremia (B, D, and F) were immunostained with protein gene product 9.5 (PGP 9.5, 1: 1000; UltraClone, Isle of Wight, England). Original magnifications ×200 (A and B) and ×400 (C-F). A, In the skin of a control subject at a low magnification, there are prominent subepidermal nerve plexuses (SNP) between the epidermis (Epi) and dermis (Derm). Intraepidermal nerve fibers (arrows) are observed but require a higher magnification to resolve the details. B, In the skin of a patient with uremia, intraepidermal nerve fibers are nearly depleted and only a small fragment of SNP is seen. C, In this control subject, an intraepidermal nerve fiber ascends from the subepidermal nerve, which shows linear dense immunoreactivities at the border of the epidermis and dermis. D, In the patient with uremia, the epidermis becomes denervated and the SNP is almost absent and some nerve fibers become fragmented, indicating degeneration. E, In the dermis of the control skin, individual nerves in the nerve bundles show intense linear immunoreactivity. F, The nerve fibers in the dermis of the patient with uremia exhibit swelling and segmented features of degeneration. Bar = 50 μm for A and B and 25 μm for C to F. Figure Legend:

2. Date of download: 6/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin Denervation and Its Clinical Significance in Late-Stage Chronic Kidney Disease Arch Neurol. 2011;68(2):200-206. doi:10.1001/archneurol.2010.372 The relationship between intraepidermal nerve fiber (IENF) densities and duration of chronic kidney disease. The IENF density is negatively correlated with the duration of renal disease (P =.03). The solid line is the regression line. The dotted lines are 95% confidence intervals. Figure Legend:

3. Date of download: 6/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin Denervation and Its Clinical Significance in Late-Stage Chronic Kidney Disease Arch Neurol. 2011;68(2):200-206. doi:10.1001/archneurol.2010.372 Comparison of abnormal rates on large- and small-fiber examinations in late-stage chronic kidney disease. The graph shows the proportion of abnormal results of intraepidermal nerve fiber (IENF) density on skin biopsy of the leg (67.5%), sympathetic skin response (SSR) in the sole (62.5%), R-R interval variability (RRIV) at rest or during deep breathing (53.6%), and sural (20%) and peroneal (32.5%) nerves of nerve conduction studies. Figure Legend:

4. Date of download: 6/27/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Skin Denervation and Its Clinical Significance in Late-Stage Chronic Kidney Disease Arch Neurol. 2011;68(2):200-206. doi:10.1001/archneurol.2010.372 The relationship between skin innervation and autonomic function test results. The intraepidermal nerve fiber (IENF) density was positively correlated with the R-R interval variability (RRIV) at rest (P =.009). The solid line is the regression line. The dotted lines are 95% confidence intervals. Figure Legend: