A girl with chronic glomerulonephritis reached terminal uremia at the age of 111/2 years and developed peripheral neuropathy characterized by "burning foot syndrome," sensory loss, severe weakness of the left leg, and bilaterally decreased nerve conduction velocities. Recovery was virtually complete after eight months of intensive hemodialysis. Serial determinations of transketolase activity (TKA) inhibition by the patient's serum were performed. The TKA inhibition by the patient's serum, initially high, returned to normal as clinical evidence of neuropathy disappeared. Nerve conduction velocities remained below normal during the period of observation.