The role of neurotransmitters in the genesis of uremic encephalopathy

Int J Artif Organs. 1984 Mar;7(2):101-6.

Abstract

To classify the influence of neurotransmitters in the genesis of uremic encephalopathy we studied cerebrospinal fluid (CSF) and plasma (P) amino acid (AA) concentration, in patients undergoing various dialytic treatments (hemodialysis = HD, intermittent and continuous peritoneal dialysis = IPD and CAPD). HD causes a significant decrease in CSF/P ratios of branched chain AA (BCAA) and a significant increase in CSF Glycine/Valine ratio, suggesting an augmented brain uptake of Glycine at detriment of Valine. In IPD the general trend of Aromatic AA/BCAA ratio suggests a preferential transport of Aromatic AA through the blood brain barrier. The differences between IPD and HD are confirmed by data concerning metabolites of Serotonin and Dopamine: CSF concentrations of 5- Hydroxyindoleacetic acid and Homovanillic acid are low in HD but high in IPD. So, a reduced (in HD) and an increased (in IPD) activity of monoamine systems could be at the basis of some neurological disturbances appearing in uremia.

MeSH terms

  • Adolescent
  • Adult
  • Amino Acids / blood
  • Amino Acids / cerebrospinal fluid
  • Brain Diseases / cerebrospinal fluid
  • Brain Diseases / etiology
  • Brain Diseases / metabolism*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurotransmitter Agents / blood
  • Neurotransmitter Agents / cerebrospinal fluid
  • Neurotransmitter Agents / metabolism
  • Neurotransmitter Agents / physiology*
  • Peritoneal Dialysis, Continuous Ambulatory
  • Renal Dialysis
  • Uremia / cerebrospinal fluid
  • Uremia / metabolism*
  • Uremia / therapy

Substances

  • Amino Acids
  • Neurotransmitter Agents