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Morphological evaluation of sympathetic renal innervation in patients with autosomal dominant polycystic kidney disease

  • Valentina Rovella
  • Manuel Scimeca
  • Elena Giannini
  • Adriana D’Ercole
  • Erica Giacobbi
  • Annalisa Noce
  • Gabriele D’Urso
  • Alessandro Anselmo
  • Pierluigi Bove
  • Giuseppe Santeusanio
  • Elena Bonanno
  • Maurizio Casasco
  • Silvestro Mauriello
  • Nicola Di Daniele
  • Alessandro MaurielloEmail author
  • Lucia Anemona
Original Article

Abstract

Several evidences support the hypothesis that patients affected by autosomal dominant polycystic kidney disease (ASPKD) show a sympathetic renal hyperactivity. Nevertheless, no morphological evidences are available yet. Therefore, the aim of the study was to demonstrate that an increase in sympathetic renal artery innervation was present in the ADPKD patients by using histological methods. In addition, here we correlated the sympathetic renal artery innervation with the evolutionary state of ADPKD (increase in volume of kidney, onset of chronic renal failure and hypertension). To this end, peri-adventitial innervation of renal arteries was studied using morphological methods from 49 patients in total: 29 underwent surgical nephrectomies for ADPKD and 20 non-dialysis patients (CTRL group) undergoing nephrectomy for other diseases. Nerve density (number of nerves per mm2) was evaluated in the peri-adventitial tissue in a concentric ring that was located within 2 mm from the beginning of the adventitia by using immunohistochemistry. The total nerve density was significantly increased in the ADPKD group (1.26 ± 0.82 × mm2) as compared to controls (0.78 ± 0.40 × mm2) (p = 0.02). Hypertensive patients with ADPKD showed a greater nerve density than control hypertensives. However, the increase in renal sympathetic innervation in the ADPKD patients was found to be independent of hypertension, resistance to antihypertensive therapy, age, sex and kidney volume, as demonstrated by the uni and multivariate analysis. In conclusion, our study better clarifies the effect of sympathetic hyperactivity in the progression of polycystic disease.

Keywords

ADPKD Histology Sympathetic renal hyperactivity Renal denervation 

Notes

Acknowledgements

Manuel Scimeca is recipient of a fellowship from the “Fondazione Umberto Veronesi” (FUV).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

The study was approved by Institutional Ethical Committee of the “Policlinico Tor Vergata.”Experimental procedures here reported were performed in agreement with the The Code (n°54/14) of Ethics of the World Medical Association (Declaration of Helsinki).

Research involving human participants and/or animals

This study was approved and conducted in accordance with the guidelines of the Human Research Committee of "Fondazione Policlinico Tor Vergata" (n°54/14).

Informed consent

Each subject signed an informed consent before surgery.

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Copyright information

© Italian Society of Nephrology 2019

Authors and Affiliations

  • Valentina Rovella
    • 1
  • Manuel Scimeca
    • 2
    • 3
  • Elena Giannini
    • 2
  • Adriana D’Ercole
    • 2
  • Erica Giacobbi
    • 2
  • Annalisa Noce
    • 1
  • Gabriele D’Urso
    • 1
  • Alessandro Anselmo
    • 4
  • Pierluigi Bove
    • 5
  • Giuseppe Santeusanio
    • 2
  • Elena Bonanno
    • 2
  • Maurizio Casasco
    • 6
  • Silvestro Mauriello
    • 7
  • Nicola Di Daniele
    • 1
  • Alessandro Mauriello
    • 2
    • 8
    Email author
  • Lucia Anemona
    • 2
  1. 1.Division of Internal Medicine and NephrologyPoliclinico Tor VergataRomeItaly
  2. 2.Anatomic Pathology, Department of Experimental MedicineUniversity of Rome “Tor Vergata”RomeItaly
  3. 3.San Raffaele UniversityRomeItaly
  4. 4.Transplantation SurgeryDepartment of Surgery Policlinico Tor Vergata FoundationRomeItaly
  5. 5.Urology, Department of SurgeryUniversity of Rome “Tor Vergata”RomeItaly
  6. 6.Federazione Medico Sportiva ItalianaRomeItaly
  7. 7.Department of Biomedicine and PreventionTor Vergata University of RomeRomeItaly
  8. 8.Tor Vergata Oncoscience Research (TOR)University of Rome “Tor Vergata”RomeItaly

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