Selective afferent renal denervation mitigates renal and splanchnic sympathetic nerve overactivity and renal function in chronic kidney disease-induced hypertension
| Autor: | Ruy R. Campos, Amanda C Veiga, Maycon I.O. Milanez, Erika E. Nishi, Nathalia R. Lopes, Cássia T. Bergamaschi, Michelle L. Garcia, Giovanna R. Ferreira, Camila Pereira Santos, Polliane M. Carvalho, Fernando Neves Nogueira, Lila Missae Oyama, Kátia De Angelis, Guiomar Nascimento Gomes |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Hypertension Renal Sympathetic Nervous System Physiology medicine.medical_treatment Urology Renal function 030204 cardiovascular system & hematology Kidney urologic and male genital diseases 03 medical and health sciences 0302 clinical medicine Internal Medicine Renal fibrosis Animals Medicine Arterial Pressure 030212 general & internal medicine Renal Insufficiency Chronic Denervation business.industry medicine.disease Nephrectomy Rats medicine.anatomical_structure Cardiology and Cardiovascular Medicine business Splanchnic Homeostasis Kidney disease |
| Zdroj: | Journal of Hypertension. 38:765-773 |
| ISSN: | 1473-5598 0263-6352 |
| Popis: | Background Clinical and experimental evidence have shown that renal denervation, by removing both the sympathetic and afferent nerves, improves arterial hypertension and renal function in chronic kidney disease (CKD). Given the key role of renal sympathetic innervation in maintaining sodium and water homeostasis, studies have indicated that the total removal of renal nerves leads to impaired compensatory mechanisms during hemodynamic challenges. Method In the present study, we hypothesized that afferent (or sensory) fibers from the diseased kidney contribute to sympathetic overactivation to the kidney and other target organ, such as the splanchnic region, contributing to hypertension in CKD. We used a method to remove selectively the afferent renal fibers (periaxonal application of 33 mmol/l capsaicin) in a rat model of CKD, the 5/6 nephrectomy. Results Three weeks after afferent renal denervation (ARD), we found a decrease in mean arterial pressure (∼15%) and normalization in renal and splanchnic sympathetic nerve hyperactivity in the CKD group. Interestingly, intrarenal renin--angiotensin system, as well as renal fibrosis and function and proteinuria were improved after ARD in CKD rats. Conclusion The findings demonstrate that afferent fibers contribute to the maintenance of arterial hypertension and reduced renal function that are likely to be mediated by increased sympathetic nerve activity to the renal territory as well as to other target organs in CKD. |
| Databáze: | OpenAIRE |
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