Fig. 1

Longitudinal outcomes of clinical and molecular substrate parameters. Clinical outcomes measured by walking time and steps (a), malleolar vibratory sensation (b) and nerve conduction study of ulnar nerve (c) prior to the first dialysis session (“pre-dialysis”), 6- and 12-months after initiation of dialysis (“post-dialysis”). Levels of thymidine and deoxyuridine in serum (d), urine (e) and CSF (f) measured at baseline, 6- and 12-month follow-up each time directly before a dialysis session (“predialysis”), directly after a dialysis session (“post dialysis”) as well as 24 h after a dialysis session (“24 h–post-dialysis”). MRI showed advanced leukencephalopathy with symmetrical affection of frontal, parietal and temporal regions (g) and without lactate peak (arrow; related spectrum encircled) in MR spectroscopy (MRS) (h; white curve = measured signal, red curve = automatic metabolite fit, blue curve = 6th order polynomial representing the baseline; Abbreviations: [a.u.] = artificial unit; MI = myoinositol; NAA = N-acetyl aspartate; Cho = choline; Cr1 = creatine; DML = distal motor latency)