title: The role of neurotransmitters in the genesis of uremic encephalopathy.
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: D000293:Adolescent; D000328:Adult; D000596:Amino Acids / Q000097:blood / Q000134:cerebrospinal fluid; D001927:Brain Diseases / Q000134:cerebrospinal fluid / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018377:Neurotransmitter Agents / Q000097:blood / Q000134:cerebrospinal fluid / Q000378:metabolism / Q000502:physiology*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D006435:Renal Dialysis; D014511:Uremia / Q000134:cerebrospinal fluid / Q000378:metabolism* / Q000628:therapy
chemical_list: D000596:Amino Acids; D018377:Neurotransmitter Agents