The Dialysis Encephalopathy Syndrome

Alfrey, Allen C.; LeGendre, Gary R.; Kaehny, William D.

doi:10.1056/nejm197601222940402

Cited by 1,496 publications

(146 citation statements)

References 16 publications

Supporting

Mentioning

135

Contrasting

Unclassified

Order By: Relevance

“…Humans ingest about 30 mg of Al daily, mostly as a food contaminant, but only about 10-20 pug is actually absorbed (15). A substantial amount of the absorbed Al is deposited in the bones and brain (15).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Ferritin: isolation of aluminum-ferritin complex from brain.

Fleming

Joshi

1987

Proc. Natl. Acad. Sci. U.S.A.

137

View full text Add to dashboard Cite

Ferritin was isolated from the livers and brains of two groups of rats, one of which was fed aluminum chloride (100 ,uM) for 1 year in the drinking water. Brain tissue contained about one-third ofthe amount offerritin found in the liver. While brain ferritin from normal rats contained 42.1 ± 14.3 mol of aluminum, that from the aluminum-fed group contained 115.4 ± 48.3 mol of aluminum per mol of ferritin. Liver ferritin from both groups contained similar amounts of both aluminum and iron, and the amounts were less than that found associated with brain ferritin. Ferritin isolated from the brains of patients who died of Alzheimer disease contained more aluminum and more iron than that from age-matched controls. Human brain ferritin is composed of two types of subunits-about 70% heavy chain (Mr, 22,000) and 30% light chain (Mr,19,500). The isoelectric focusing pattern of human brain ferritin was considerably different from that of human liver. Only 5 of the 20 brain ferritin bands migrated similarly to the acidic isoferritins from the liver, and the major component of brain ferritin, representing 30% of the total ferritin, had a pI of 8.0.

show abstract

mentioning

confidence: 99%

“…A substantial amount of the absorbed Al is deposited in the bones and brain (15). Thus, under normal physiological conditions, the accumulation of Al results from chronic low-level exposure.…”

mentioning

confidence: 99%

Ferritin: isolation of aluminum-ferritin complex from brain.

Fleming

Joshi

1987

Proc. Natl. Acad. Sci. U.S.A.

137

View full text Add to dashboard Cite

show abstract

“…Since the occurrence of dialysis dementia in the 1970s, 6 the measurement of aluminum in serum routinely has been carried out in medical institution. This is why a simple, rapid, and highly sensitive method for the assay of aluminum is required.…”

Section: Introductionmentioning

confidence: 99%

Spectrophotometric Determination of Aluminum with m-Carboxyphenylfluorone, a Novel Chemical Probe, and Its Application

et al. 2005

View full text Add to dashboard Cite

A highly spectrophotometric method for the determination of aluminum was developed. This method used the color reaction between m-carboxyphenylfluorone (MCPF) as a novel chemical probe and aluminum in the presence of a surfactant, poly(N-vinylpyrrolidone) (PVP, K-90) (0.03 -1.40 µg of aluminum in a final volume of 10 ml at 561 nm). The proposed method showed excellent sensitivity (molar absorptibity of 1.70 × 10 5 l mol -1 cm -1 ) and reproducibility (within-day precision: RSD = 0.35% n = 6, between-day precision: RSD = 0.44% n = 6). Linearity was achieved over the range 3 -140 µg L -1 with a correlation coefficient of 0.9999, and the effects of foreign substances were low.

show abstract

“…The increased incidence of atherosclerosis may lead to cerebrovascular disease; uraemic toxins cause periph-\\·as discovered to be caused by aluminium in 1976 \\hen abnormally high levels of the element were found in brain studied at post mortem (2). The sources of aluminium were identified as contaminated water used to prepare dialysate, and oral aluminium containing phosphate binders used to control hyperphosphataemia.…”

Section: Introductionmentioning

confidence: 99%

Pterin Metabolism In Haemodialysis Patients

et al. 1989

View full text Add to dashboard Cite

SummaryPatients undertaking maintenance haemodialysis may develop a variety of neurological disorders, the most serious of which is aluminium induced encephalopathy. Abnormally raised serum concentrations of pterins are found in dialysis patients, and neonates with tetrahydrobiopterin deficiency develop mental dysfunction. Dihydropteridine reductase, essential for maintenance of normal levels of tetrahydrobiopterin, is inhibited when aluminium is added to brain homogenate at similar concentrations to those found in aluminium encephalopathy. We have previously shown that erythrocyte dihydropteridine reductase activity was reduced in non-encephalopathic dialysis patients and inversely related to serum aluminium concentration. Concentrations of serum biopterin derivatives were raised but not related to either aluminium or dihydropteridine reductase.In this study of 17 haemodialysis patients, serum biopterin (13.6 ± 1.3 I1g/ l) and neopterin (66.2 ± 7.4 I1g/ l) concentrations were raised compared with normal subjects' biopterin (2.4 ± 0.4 gi l) and neopterin (2.8 ± 0.4 I1g/ l) values (p = 0 .0001). When neopterin and biopterin concentrations were corrected for predialysis serum creatinine a weak relationship appeared between them (r = 0.49, P = 0.04). Erythrocyte dihydropteridine reductase was not related to the creatinine corrected neopterin (r = -0.5, p = 0.2), but there was a significant relationship between DHPR and corrected biopterin (r = 0.986, p = 0.0001) and between corrected biopterin and bone aluminium content (r = 0.68 , P = 0.03) .Our results support the possibility that aluminium causes changes in pterin metabolism which are analogous to those found in Type II hyperphenylalaninaemia. Serum biopterin concentration, corrected for pre-dialysis serum creatinine, can be used satisfactorily to study tetrahydrobiopterin metabolism in haemodialysis patients. However neopterin/ biopterin ratios are unpredicta bly disturbed and cannot be so used. Serum neopterin concentrations are raised more than anticipated from the biopterin concentrations, and this may be due to neopterin release from macrophages activated by dialysis membranes and /or reduced conversion of dihydroneopterin triphosphate to tetrahydrobiopterin.

show abstract

The Dialysis Encephalopathy Syndrome

Cited by 1,496 publications

References 16 publications

Ferritin: isolation of aluminum-ferritin complex from brain.

Ferritin: isolation of aluminum-ferritin complex from brain.

Spectrophotometric Determination of Aluminum with m-Carboxyphenylfluorone, a Novel Chemical Probe, and Its Application

Pterin Metabolism In Haemodialysis Patients

Contact Info

Product

Resources

About