Abstract
The renal sympathetic innervation of the kidney exerts significant effects on multiple aspects of renal function, including renal haemodynamics, tubular sodium and water reabsorption and renin secretion. These effects constitute an important control system which is important in the physiological regulation of arterial pressure and total body fluid and sodium homeostasis. Abnormalities in this regulatory mechanism have pathophysiological consequences and are manifest in clinically relevant human disease states. Decreased renal sympathetic nerve activity results in impaired renin secretion, the inability to conserve sodium normally and an attenuated ability to dispose of both acute and chronic sodium loads. Increased renal sympathetic nerve activity contributes significantly to the excess renal sodium retention and related renal abnormalities observed in both hypertension and oedema forming conditions, such as cardiac failure, cirrhosis and nephrotic syndrome.
Similar content being viewed by others
References
Kopp UC, Dibona GF. The neural control of renal function. In: Seldin DW, Giebisch G, eds.The Kidney—Physiology and Pathophysiology. New York: Raven, 1992; 1157–1204.
Moss NG, Colindres RE, Gottschalk CW. Neural control of renal function. In: Windhager EE, ed.Handbook of Physiology. Section 8: Renal Physiology. Oxford: Oxford University Press, 1992: 1061–1128.
Kopp UC, DiBona GF. Effects of renal nerves and neurotransmitters on renal function. In: Brenner BM, Rector FC, eds.The Kidney. Philadelphia, PA: Saunders, 1994: in press.
Aperia A, Ibarra F, Svensson L-B, Klee C, Greengard P, Calcineurin mediates α-adrenergic stimulation of Na+,K+-ATPase activity in renal tubule cells.Proc Natl Acad Sci 1992;89: 7394–7397.
DiBona GF, Sawin LL. Renal nerve activity in conscious rats during volume expansion and depletion.Am J Physiol 1985;248: F15-F23.
Miki K, Harashida Y, Sagawa S, Shiraki K. Renal sympathetic nerve activity and natriuresis during water immersion in conscious dogs.Am J Physiol 1989;256: R299-R305.
Miki K, Hayashida Y, Tajima F, Iwamoto J, Shiraki K. Renal sympathetic nerve activity and renal responses during head-up tilt in conscious dogs.Am J Physiol 1989;257: R337-R343.
Miki K, Hayashi Y, Shiraki K. Cardiac-renal-neural reflex plays a major role in natriuresis induced by left atrial distension.Am J Physiol 1992;264: R369-R375.
Gill JR, Bartter FC. Adrenergic nervous system in sodium metabolism. II. Effects of guanethidine on the renal response to sodium deprivation in normal man.New Engl J Med 1966;275: 1466–1471.
Wilcox CS, Aminoff MJ, Slater JDH. Sodium homeostasis in patients with autonomic failure.Clin Sci 1977;53: 321–328.
Sutters M, Wakefield C, O'Neil K,et al. The cardiovascular, endocrine and renal response of tetraplegic and paraplegic subjects to dietary sodium restriction.J Physiol 1992;457: 515–523.
Greenberg SG, Tershner S, Osborn JL. Neurogenic regulation of rate of achieving sodium balance after increasing sodium intake.Am J Physiol 1991;261: F300-F307.
DiBona GF. Renal innervation and denervation: lessons from renal transplantation reconsidered.Artificial Organs 1987:11: 457–462.
Vertes JV, Cangiano JL, Berman LB,et al. Hypertension in endstage renal disease.N Engl J Med 1969;280: 978–982.
Lee MS, Neff MS, Slifkin RF,et al. Bilateral nephrectomy for hypertension in patients with chronic renal failure on a dialysis program.J Urol 1978;119: 20.
Converse RL, Jacobsen TN, Toto RD, Jost CMT, Cosentino F, Fouad-Tarazi F, Victor RG. Sympathetic overactivity in patients with chronic renal failure.New Engl J Med 1992;327: 1912–1918.
DiBona GF. Role of renal nerves in edema formation.News in Physiol Sci 1994;9: in press.
Norvell JE. Renal nerves: are they essential?New Engl J Med 1970;283: 261.
Author information
Authors and Affiliations
Additional information
This paper is based on a lecture given by Dr G. F. DiBona to the Clinical Autonomic Research Society in November 1993
Rights and permissions
About this article
Cite this article
DiBona, G.F. Neural control of renal function in health and disease. Clinical Autonomic Research 4, 69–74 (1994). https://doi.org/10.1007/BF01828841
Issue Date:
DOI: https://doi.org/10.1007/BF01828841