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Impaired Autonomic Blood Pressure and Blood Volume Control in Chronic Renal Failure

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Cardiorenal Syndrome

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Abstract

Renal failure is characterized by impairment in autonomic cardiovascular control, with reduced baroreceptor heart-rate modulation and altered cardiopulmonary reflex control of sympathetic vasoconstrictor tone. The autonomic abnormalities also include chemoreflex activation and muscle metaboreceptor reflex dysfunction. These reflex changes contribute to disease progression by promoting and aggravating the adrenergic overdrive seen in patients with renal failure. The adverse cardiovascular effects of this autonomic impairment make autonomic dysfunction a target for the therapeutic approach to renal failure.

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References

  1. Robinson TG, Carr SJ (2002) Cardiovascular autonomic dysfunction in uremia. Kidney Int 62:1921–1932

    Article  PubMed  Google Scholar 

  2. Bongartz LG, Cramer MJ, Doevendans PA et al (2005) The severe cardiorenal syndrome: “Guyton revisited”. Eur Heart J 26:11–17

    Article  PubMed  Google Scholar 

  3. Chesterton LJ, McIntyre CW (2005) The assessment of baroreflex sensitivity in patients with chronic kidney disease: implications for vasomotor instability. Curr Opin Nephrol Hypertens 14:586–591

    Article  PubMed  Google Scholar 

  4. Grassi G, Arenare F, Pieruzzi F et al (2009) Sympathetic activation in cardiovascular and renal disease. J Nephrol 22:190–195

    PubMed  Google Scholar 

  5. Pickering TG, Gribbin B, Oliver DO (1972) Baroreflex sensitivity in patients on long-term haemodialysis. Clin Sci 43:645–657

    CAS  PubMed  Google Scholar 

  6. Lazarus JM, Hampers CL, Lowrie EG et al (1973) Baroreceptor activity in normotensive and hypertensive uremic patients. Circulation 47:1015–1021

    CAS  PubMed  Google Scholar 

  7. Grassi G, Parati G, Pomidossi G et al (1987) Effects of haemodialysis and kidney transplantation on carotid and cardiopulmonary baroreflexes in uremic patients. J Hypertens 5 (Suppl. 5):S367–S369

    Google Scholar 

  8. Johansson M, Gao SA, Friberg P et al (2007) Baroreflex effectiveness index and baroreflex sensitivity predict all-cause mortality and sudden death in hypertensive patients with chronic renal failure. J Hypertens 25:163–168

    Article  CAS  PubMed  Google Scholar 

  9. Chan CT, Shen XS, Picton P et al (2008) Nocturnal home hemodialysis improves baroreflex effectiveness index of end-stage renal disease patients. J Hypertens 26:1795–1800

    Article  CAS  PubMed  Google Scholar 

  10. Ligtenberg G, Blankestijn PJ, Oey PL et al (1999) Reduction of sympathetic hyperactivity by enalapril in patients with chronic renal failure. N Engl J Med 29;340:1321–1328

    Article  Google Scholar 

  11. Klein IH, Ligtenberg G, Oey PL et al (2001) Sympathetic activity is increased in polycystic kidney disease and is associated with hypertension. J Am Soc Nephrol 12:2427–2433

    CAS  PubMed  Google Scholar 

  12. Mancia G, Ludbrook J, Ferrari A et al (1978) Baroreceptor reflexes in human hypertension. Circ Res 43:170–177

    CAS  PubMed  Google Scholar 

  13. Grassi G, Cattaneo BM, Seravalle G et al (1998) Baroreflex control of sympathetic nerve activity in essential and secondary hypertension. Hypertension 31:68–72

    CAS  PubMed  Google Scholar 

  14. Ferrari AU, Grassi G, Mancia G (1990) The cardiopulmonary reflex in hypertension. In: Laragh J, Brenner B (eds) Hypertension: pathophysiology, diagnosis and management. Raven Press, New York, pp 349–358

    Google Scholar 

  15. Hering D, Zdrojewski Z, Król E et al (2007) Tonic chemoreflex activation contributes to the elevated muscle sympathetic nerve activity in patients with chronic renal failure. J Hypertens 25:157–161

    Article  CAS  PubMed  Google Scholar 

  16. Park J, Campese VM, Middlekauff HR (2008) Exercise pressor reflex in humans with endstage renal disease. Am J Physiol Regul Integr Comp Physiol 295:R1188–R1194

    CAS  PubMed  Google Scholar 

  17. London GM, Marchais SJ, Safar ME et al (1990) Aortic and large artery compliance in endstage renal failure. Kidney Int 37:137–142

    Article  CAS  PubMed  Google Scholar 

  18. Guérin AP, London GM, Marchais SJ et al (2000) Arterial stiffening and vascular calcifications in end-stage renal disease. Nephrol Dial Transplant 15:1014–1021

    Article  PubMed  Google Scholar 

  19. Mark PB, Patel RK, Jardine AG (2007) Are we overestimating left ventricular abnormalities in end-stage renal disease? Nephrol Dial Transplant 22:1815–1819

    Article  PubMed  Google Scholar 

  20. Grassi G, Giannattasio C, Cléroux J et al (1988) Cardiopulmonary reflex before and after regression of left ventricular hypertrophy in essential hypertension. Hypertension 12:227–237

    CAS  PubMed  Google Scholar 

  21. Mancia G, Luscher TF, Shepherd JT et al (2007) Cardiovascular regulation: Basic considerations. In: Willerson JT, Cohn JN, Wellens HJJ, Holmes DR Jr (eds) Cardiovascular medicine. Springer Verlag, London, pp. 1525–1536

    Chapter  Google Scholar 

  22. Zoccali C, Mallamaci F, Parlongo S et al (2002) Plasma norepinephrine predicts survival and incident cardiovascular events in patients with end-stage renal disease. Circulation 105:1354–1359

    Article  CAS  PubMed  Google Scholar 

  23. Neumann J, Ligtenberg G, Oey L et al (2004) Moxonidine normalizes sympathetic hyperactivity in patients with eprosartan-treated chronic renal failure. J Am Soc Nephrol 15:2902–2907

    Article  CAS  PubMed  Google Scholar 

  24. Neumann J, Ligtenberg G, Klein IH et al (2007) Sympathetic hyperactivity in hypertensive chronic kidney disease patients is reduced during standard treatment. Hypertension 49:506–510

    Article  CAS  PubMed  Google Scholar 

  25. Agarwal A, Anand IS, Sakhuja V et al (1991) Effect of dialysis and renal transplantation on autonomic dysfunction in chronic renal failure. Kidney Int 40:489–495

    Article  CAS  PubMed  Google Scholar 

  26. Baldamus CA, Mantz P, Kachel HG et al (1984) Baroreflex in patients undergoing hemodialysis and hemofiltration. Contrib Nephrol 41:409–414

    CAS  PubMed  Google Scholar 

  27. Chan CT, Shen XS, Picton P et al (2008) Nocturnal home hemodialysis improves baroreflex effectiveness index of end-stage renal disease patients. J Hypertens 26:1795–1800

    Article  CAS  PubMed  Google Scholar 

  28. Zilch O, Vos PF, Oey PL et al (2007) Sympathetic hyperactivity in haemodialysis patients is reduced by short daily haemodialysis. J Hypertens 25:1285–1289

    Article  CAS  PubMed  Google Scholar 

  29. Rubinger D, Backenroth R, Sapoznikov D (2009) Restoration of baroreflex function in patients with end-stage renal disease after renal transplantation. Nephrol Dial Transplant 24:1305–1313

    Article  PubMed  Google Scholar 

  30. Koomans HA, Ligtenberg G (2001) Mechanisms and consequences of arterial hypertension after renal transplantation. Transplantation 72(6 Suppl):S9–S12

    CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Clinica Medica, Department of Clinical Medicine and Prevention, University of Milano-Bicocca San Gerardo Hospital, Monza, Milan, Italy

    Guido Grassi, Raffaella Dell’Oro, Fosca Quarti-Trevano & Giuseppe Mancia

Authors
  1. Guido Grassi
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  2. Raffaella Dell’Oro
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  3. Fosca Quarti-Trevano
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  4. Giuseppe Mancia
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Editor information

Editors and Affiliations

  1. Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

    Adel E. Berbari

  2. Clinica Medica Department of Clinical Medicine and Prevention, University of Milano-Bicocca San Gerardo Hospital, Monza, Milan, Italy

    Giuseppe Mancia

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© 2010 Springer-Verlag Italia

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Grassi, G., Dell’Oro, R., Quarti-Trevano, F., Mancia, G. (2010). Impaired Autonomic Blood Pressure and Blood Volume Control in Chronic Renal Failure. In: Berbari, A.E., Mancia, G. (eds) Cardiorenal Syndrome. Springer, Milano. https://doi.org/10.1007/978-88-470-1463-3_22

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  • DOI: https://doi.org/10.1007/978-88-470-1463-3_22

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1462-6

  • Online ISBN: 978-88-470-1463-3

  • eBook Packages: MedicineMedicine (R0)

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