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Mild chronic renal insufficiency induces sympathetic overactivity

Journal of Human Hypertension volume 15, pages 401–406 (2001)Cite this article

Abstract

The objectives of this study were to evaluate baseline sympathetic nerve activity as well as the mechanisms of sympathetic overactivity in mild chronic renal insufficiency hypertension. Seven hypertensives with mild renal insufficiency, seven hypertensives with normal renal function and seven normotensives, age and weight-matched were studied on one session to evaluate baseline muscle sympathetic nerve activity measured in the peroneal nerve. The mild renal insufficiency hypertensives and the hypertensives with normal renal function were also studied to evaluate arterial baroreflex control of muscle sympathetic nerve activity assessed by increasing and decreasing blood pressure through continuous infusion of phenylephrine and sodium nitroprusside respectively. Baseline muscle sympathetic nerve activity was significantly higher in mild renal insufficiency hypertensives (34 bursts/min) when compared to hypertensives with normal renal function (24 bursts/min) and to normotensives (16 bursts/min). Baroreflex control of muscle sympathetic nerve activity was (in absolute values) 15.2 in hypertensives with normal renal function vs 2.6 in mild renal insufficiency hypertensives (P < 0.05) during phenylephrine and 6.3 vs 8.2 during nitroprusside infusions. Mild renal insufficiency hypertensives showed sympathetic overactivity when compared to hypertensives with normal renal function and to normotensives. This finding demonstrates that elevated sympathetic activity may be precociously detected in renal insufficiency. Baroreflex gain to phenylephrine was blunted in mild renal insufficiency hypertensives when compared to hypertensives with normal renal function, suggesting that bradycardic response in mild renal insufficiency is blunted.

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References

  1. Campese VM Is hypertension in chronic renal failure neurogenic in nature? Nephrol Dial Transplant 1994 9 741–742

    CAS  PubMed  Google Scholar 

  2. Cangiano JL et alNormal renin uremic hypertension. Study of cardiac hemodynamics, plasma volume, extracellular fluid volume and renin angiotensin system Arch Intern Med 1976 136 17–23

    Article  CAS  Google Scholar 

  3. Converse Jr RL et alSympathetic overactivity inpatients with chronic renal failure N Engl J Med 1992 327 1912–1918

    Article  CAS  Google Scholar 

  4. Lilley JJ, Golden J, Stone RA Adrenergic regulation of blood pressure in chronic renal failure J Clin Invest 1976 57 1190–1200

    Article  CAS  Google Scholar 

  5. Sahn DJ, de Maria A, Kisslo J, Weyman A Recommendations regarding quantitation in M-mode echocardiography. Results of a survey of echocardiographic measurements Circulation 1978 58 1072–1083

    Article  CAS  Google Scholar 

  6. Hammond IW et alThe prevalence and correlates of echocardiographic left ventricular hypertrophy among employedpatients with uncomplicated hypertension J Am Coll Cardiol 1986 7 639–650

    Article  CAS  Google Scholar 

  7. Ganau A et alPatterns of left ventricular hypertrophy and geometric remodeling in essential hypertension J Am Coll Cardiol 1992 19 1550–1558

    Article  CAS  Google Scholar 

  8. Mark AL Regulation of sympathetic nerve activity in mild human hypertension J Hypertens 1990 8 (Suppl 7) S67–S75

    Google Scholar 

  9. Hagbarth KE, Valbo A Pulse and respiratory grouping of sympathetic impulses in human muscle nerves Acta Physiol Scand 1968 74 96–108

    Article  CAS  Google Scholar 

  10. Campese VM, Kogosov E, Koss M Renal afferent denervation prevents the progression of renal disease in the renal ablation model of chronic renal failure in the rat Am J Kidney Dis 1995 26 861–865

    Article  CAS  Google Scholar 

  11. Gattone VH, Evan AP, Overhage JM, Severs WB Developing renal innervation in the spontaneously hypertensive rat: evidence for a role of the sympathetic nervous system in renal damage J Hypertens 1990 8 423–428

    Article  Google Scholar 

  12. Saxena PR Interaction between the renin-angiotensin-aldosterone and sympathetic nervous system J Cardiovasc Pharmacol 1992 19 (Suppl 6) S80–S88

    Article  Google Scholar 

  13. Schmeider RE et alDoes the renin-angiotensin system modify cardiac structure and function in essential hypertension? Am J Med 1988 84 (Suppl 3A) 136–139

    Article  Google Scholar 

  14. Simson P Norepinephrine stimulated hypertrophy of cultured rat myocardial cells in alpha 1 adrenergic response J Clin Invest 1983 72 732–738

    Article  Google Scholar 

  15. Laks MM, Morady F, Swan HJC Myocardial hypertrophy produced by chronic infusion of subhypertensive doses of norepinephrine in the dog Chest 1973 64 75–78

    Article  CAS  Google Scholar 

  16. Agabiti-Rosei E et alCardiac function as related to adrenergic activity in hypertensive left ventricular hypertrophy J Clin Hypertens 1987 3 203–210

    CAS  PubMed  Google Scholar 

  17. Rossi MA, Carilo SV Does norepinephrine play acentral causative role in the process of cardiac hypertrophy? Am Heart J 1985 109 622–624

    Article  CAS  Google Scholar 

  18. KallfeltT BJ, Hajlmarson AC, Issaksson OG In vitro effects of catecholamines on protein synthesis in perfused rat hearts J Mol Cell Cardiol 1976 8 787–802

    Article  Google Scholar 

  19. Yamori Y, Tarazi RC, Doshima A Effect of beta-receptor blocking agents on cardiovascular structural changes in spontaneous hypertensive rats Clin Sci 1980 59 457S–460S

    Article  CAS  Google Scholar 

  20. Watson AJ, Di Pette D Baroreflex sensitivity and pressor responses in a rat model of uremia Clin Sci 1985 69 637–640

    Article  CAS  Google Scholar 

  21. Agarwal A, Anand IS, Sakhuja V, Chugh KS Effect of dialysis and renal transplantation on autonomic dysfunction in chronic renal failure Kidney Int 1991 40 489–495

    Article  CAS  Google Scholar 

  22. Tomiyama O et alBaroreflex sensitivity in renal failure Clin Sci 1992 58 21–27

    Article  Google Scholar 

  23. Meyrelles SS, Tinucci T, Hollanda HEM, Mion D Jr Baroreflex control of muscle sympathetic nerve activity in mild hypertension Am J Hypertens 1997 10 162–167

    Article  CAS  Google Scholar 

  24. Guo GB, Abbound F Angiotensin II attenuates baroreflex control of heart rate and sympathetic activity Am J Physiol 1984 246 H80–H89

    CAS  PubMed  Google Scholar 

  25. Moreira ED, de Oliveira M, Krieger EM Impaired baroreflex control of heart rate in high-renin renal hypertension J Hypertens 1988 6 619–625

    Article  CAS  Google Scholar 

  26. Berenguer LM et alRole of renin-angiotensin system in the impairment of baroreflex control of heart rate in renal hypertension J Hypertens 1991 9 1127–1133

    CAS  PubMed  Google Scholar 

  27. Rostrand SG, Brunzel JD, Cannon RO, Victor RG Cardiovascular complications in renal failure J Am Soc Nephrol 1991 2 1053–1062

    Google Scholar 

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Authors and Affiliations

  1. University of Sao Paulo General Hospital Nephrology Division, Hypertension Unit, University of Sao Paulo School of Medicine Sao Paulo, Brazil

    T Tinucci, SB Abrahão, JL Santello & D Mion Jr

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  1. T Tinucci
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  2. SB Abrahão
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  3. JL Santello
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  4. D Mion Jr
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Tinucci, T., Abrahão, S., Santello, J. et al. Mild chronic renal insufficiency induces sympathetic overactivity. J Hum Hypertens 15, 401–406 (2001). https://doi.org/10.1038/sj.jhh.1001149

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  • DOI: https://doi.org/10.1038/sj.jhh.1001149

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