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In the kidney, interstitial nephritis and severe degeneration and necrosis of the tubular epithelial cells were the main histopathological changes

In accordance with the higher vulnerability of lower-limb long axons to injury, DPN usually develops first in the feet and then progresses proximally involving the upper limbs (dying-back type of axonal degeneration), and patients typically present with a stocking-glove like distribution of neuronal dysfunction (51)

if there is neither efficacy nor adverse events at two weeks, it is recommended to consider increasing the dose to 100 mg/day