Juan C. Idiaguez, MD; Roberto O. García-Ortez, MD; Rodrigo K. Alonso, MD
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To the Editor: Fraser and colleagues (1) have reported autonomic dysfunction in uremia. Parasympathetic pupillary denervation, however, was not mentioned. Because widespread autonomic neuropathy, which includes parasympathetic pupillary denervation (2), also occurs in patients with diabetes mellitus, a similar compromise is possible in patients with uremia. In 45 uremic patients and 33 controls (subjects at risk for autonomic neuropathy, such as persons with diabetes, alcoholism, and amyloidosis, were excluded), the supersensitivity to diluted pilocarpine (0.0625%) (3) was assessed. Two drops were instilled in one conjunctival sac in each patient, and the diameter of the pupil was measured on Polaroid camera
Idiaguez JC, García-Ortez RO, Alonso RK. Parasympathetic Denervation of the Iris in Uremia. Ann Intern Med. ;109:929. doi: 10.7326/0003-4819-109-11-929_1
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Published: Ann Intern Med. 1988;109(11):929.
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