Renal nerves in physiology, pathophysiology and interoception.

Autor: Evans LC; Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Dayton A; Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, MN, USA., Osborn JW; Department of Surgery, University of Minnesota, Minneapolis, MN, USA. osbor003@umn.edu.
Jazyk: angličtina
Zdroj: Nature reviews. Nephrology [Nat Rev Nephrol] 2025 Jan; Vol. 21 (1), pp. 57-69. Date of Electronic Publication: 2024 Oct 03.
DOI: 10.1038/s41581-024-00893-3
Abstrakt: Sympathetic efferent renal nerves have key roles in the regulation of kidney function and blood pressure. Increased renal sympathetic nerve activity is thought to contribute to hypertension by promoting renal sodium retention, renin release and renal vasoconstriction. This hypothesis led to the development of catheter-based renal denervation (RDN) for the treatment of hypertension. Two RDN devices that ablate both efferent and afferent renal nerves received FDA approval for this indication in 2023. However, in animal models, selective ablation of afferent renal nerves resulted in comparable anti-hypertensive effects to ablation of efferent and afferent renal nerves and was associated with a reduction in sympathetic nerve activity. Selective afferent RDN also improved kidney function in a chronic kidney disease model. Notably, the beneficial effects of RDN extend beyond hypertension and chronic kidney disease to other clinical conditions that are associated with elevated sympathetic nerve activity, including heart failure and arrhythmia. These findings suggest that the kidney is an interoceptive organ, as increased renal sensory nerve activity modulates sympathetic activity to other organs. Future studies are needed to translate this knowledge into novel therapies for the treatment of hypertension and other cardiorenal diseases.
Competing Interests: Competing interests: J.W.O. is a consultant for ReCor Medical, which developed the Paradise ultrasound renal denervation system. The other authors declare no competing interests.
(© 2024. Springer Nature Limited.)
Databáze: MEDLINE
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