To determine the pathogenic role of serotonin (5-HT), we investigated
5-HT metabolism in undergoing hemodialysis (HD). Mean value of platele
t 5-HT in patients undergoing HD was significantly lower than that of
normal controls (0.22 +/- 0.16 pmol/10(5) platelets versus 0.35 +/- 0.
13 pmol/10(5) platelets, p <0.02). While platelet uptake of 5-HT in no
rmal controls reached a plateau in each experiment after incubation wi
th authentic 5-HT for 60 min, platelet uptake of 5-HT in patients unde
rgoing HD reached various levels. We found significantly lower platele
t 5-HT levels in patients with diabetes mellitus (DM) after HD compare
d with those in patients with chronic glomerulonephritis (p <0.05). Th
e pathogenic role of serotonergic amplifying mechanism especially in p
atients with DM should be investigated. Second, we investigated plasma
11-dehydro-thromboxane B-2 (11-DTXB(2)) levels in patients undergoing
HD. Mean level of plasma 11-DTXB(2) concentration in patients after H
D was significantly higher than in patients before HD (32.8 +/- 17.0 p
g/ml versus 23.7 +/- 7.2 pg/ml, p <0.02). Increased plasma levels of 1
1-DTXB(2) after HD were regarded as an indication of hypercoagulation.
Our results provide evidence that several factors such as hypercoagul
ation, heparin, 5-HT uptake of platelet, or causal diseases of renal f
ailure could be responsible for the lower platelet 5-HT levels in pati
ents undergoing HD.