Sympathetic hyperactivity in chronic kidney disease: pathogenesis, clinical relevance, and treatment.
Cardiovascular morbidity and mortality importantly influence live expectancy of patients with chronic renal disease (CKD). Traditional risk factors are usually present, but several other factors have recently been identified. There is now evidence that CKD is often characterized by an activated sympathetic nervous system. This may contribute to the pathogenesis of renal hypertension, but it may also adversely affect prognosis independently of its effect on blood pressure. The purpose of this review is to summarize available knowledge on the role of the sympathetic nervous system in the pathogenesis of renal hypertension, its clinical relevance, and the consequences of this knowledge for the choice of treatment.
Neumann
Jutta
J
Department of Nephrology, University Medical Center Utrecht, The Netherlands.
Ligtenberg
Gerry
G
Klein
Inge I
II
Koomans
Hein A
HA
Blankestijn
Peter J
PJ
D000818:Animals; D002908:Chronic Disease; D006801:Humans; D006977:Hypertension, Renal / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D007668:Kidney / Q000293:injuries; D007674:Kidney Diseases / Q000503:physiopathology* / Q000628:therapy; D009569:Nitric Oxide / Q000037:antagonists & inhibitors; D006435:Renal Dialysis; D012084:Renin-Angiotensin System / Q000502:physiology; D013564:Sympathetic Nervous System / Q000503:physiopathology*
D009569:Nitric Oxide