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Sympathetic Hyperactivity in Chronic Kidney Disease: Pathophysiology and (New) Treatment Options

  • Pathogenesis of Hypertension (R Agarwal, Section Editor)
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Abstract

Abundant evidence shows that chronic kidney disease (CKD) is a disease state characterized by increased sympathetic activation. Kidney injury (ischemia) plays a central role in this pathogenesis. Sympathetic excitation is associated with an increased risk of cardiovascular morbidity and mortality. Several pharmacologic strategies are developed to decrease sympathetic activity. However, these medications have limitations. Percutaneous catheter-based renal denervation has the potential to become a new treatment option for CKD. This current report focuses on the effects of sympathetic hyperactivity in CKD, and gives an overview in experimental as well as clinical evidence for a central role of the kidneys in the pathophysiology of sympathetic hyperactivity. Moreover, the effect of pharmacologic treatment and the potential beneficial effect of renal denervation will be discussed.

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Acknowledgments

E.E. Vink was supported by a grant of the Dutch Kidney Foundation (IP10-15). R.L. de Jager is supported by a grant of The Netherlands Organisation for Health Research and Development (ZonMw grant 837004006).

Disclosure

E.E. Vink: none; R.L. de Jager: none; P.J. Blankestijn: grants from Medtronic, the Dutch Kidney Foundation, and The Netherlands Organisation for Health Research and Development, and speaker and consultancy fees from Medtronic and St. Jude Medical.

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Authors and Affiliations

  1. Department of Nephrology, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, The Netherlands

    Eva E. Vink, Rosa L. de Jager & Peter J. Blankestijn

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  1. Eva E. Vink
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  2. Rosa L. de Jager
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  3. Peter J. Blankestijn
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Correspondence to Peter J. Blankestijn.

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Vink, E.E., de Jager, R.L. & Blankestijn, P.J. Sympathetic Hyperactivity in Chronic Kidney Disease: Pathophysiology and (New) Treatment Options. Curr Hypertens Rep 15, 95–101 (2013). https://doi.org/10.1007/s11906-013-0328-5

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  • DOI: https://doi.org/10.1007/s11906-013-0328-5

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