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  • Title: The role of neurotransmitters in the genesis of uremic encephalopathy.
    Author: Biasioli S, D'Andrea G, Chiaramonte S, Fabris A, Feriani M, Ronco C, Borin D, Brendolan A, La Greca G.
    Journal: Int J Artif Organs; 1984 Mar; 7(2):101-6. PubMed ID: 6145671.
    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.
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