Autonomic regulation of kidney function

Johns, Edward J.

doi:10.1016/b978-0-444-53491-0.00017-1

Cited by 13 publications

(9 citation statements)

References 56 publications

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“…Autonomic dysfunction has been proposed as a key factor underlying higher 24-h BP variability [ 7 ]. Many individuals with CKD have autonomic dysfunction and other factors associated with high 24-h BP variability including older age, higher mean systolic BP (SBP), and higher levels of inflammation are common among individuals with CKD [ 8 – 10 ]. Therefore, we hypothesized that individuals with CKD would have higher 24-h BP variability compared to their counterparts without CKD.…”

Section: Introductionmentioning

confidence: 99%

Association between 24-hour blood pressure variability and chronic kidney disease: a cross-sectional analysis of African Americans participating in the Jackson heart study

et al. 2015

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BackgroundStudies suggest 24-h blood pressure (BP) variability has prognostic value for cardiovascular disease. Several factors associated with high 24-h BP variability are also common among individuals with chronic kidney disease (CKD). We hypothesized 24-h BP variability would be higher for individuals with versus without CKD.MethodsWe analyzed 1,022 Jackson Heart Study participants who underwent ambulatory blood pressure monitoring (ABPM). Twenty-four hour BP variability was defined by two metrics: day-night standard deviation (SDdn) and average real variability (ARV). CKD was defined as ACR ≥30 mg/g or eGFR <60 mL/min/1.73 m2.ResultsThe mean SDdn of systolic BP (SBP) was 10.2 ± 0.2 and 9.1 ± 0.1 mmHg and the mean ARV of SBP was 9.2 ± 0.2 and 8.6 ± 0.1 mmHg for those with and without CKD, respectively (each p ≤ 0.001). After adjustment for age and sex, SDdn and ARV were 0.98 mmHg (95 % CI 0.59, 1.38) and 0.52 mmHg (95 % CI 0.18, 0.86), respectively, higher among participants with versus without CKD. These differences were not statistically significant after further multivariable adjustment including 24-h mean SBP. Older age, and higher total cholesterol and 24-h mean SBP were associated with higher SDdn and ARV of SBP among participants with CKD. Mean SDdn and ARV of diastolic BP (DBP) were higher for participants with versus without CKD but these associations were not present after multivariable adjustment.ConclusionData from the current study suggest that CKD is associated with higher 24-h BP variability, but the association is primarily explained by higher mean BP among those with CKD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-015-0085-6) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Association between 24-hour blood pressure variability and chronic kidney disease: a cross-sectional analysis of African Americans participating in the Jackson heart study

et al. 2015

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“…The renal system has long been known to be key in BP and systemic osmolality regulation (Bernstein et al, 2014; Bichet, 2012a; Bichet, 2012b; Demerath et al, 2014; Tanimoto et al, 2014). The renal afferent nerves have cell bodies in the ipsilateral dorsal root ganglia and project into the spinal cord to convey sensory information to both spinal and supraspinal pathways (Johns, 2013). These neurons respond to hepatic portal vein infusion with hypertonic solution by reducing renal sympathetic nerve activity (Ishiki et al, 1991; Kopp et al, 2007; Lang et al, 1991).…”

Section: Discussionmentioning

confidence: 99%

“…Afferent renal nerves feed directly into the dorsal root ganglia (DRG) and the efferent nerves run through both the celiac and mesenteric ganglia (Johns, 2013). Decreased gastric osmolality has been shown to increase sympathetic renal nerve activity (Johns, 2013; Pedersen et al, 2011). Therefore, renal sympathetic nerves might play an important role as the efferent arm of the OPR.…”

Section: Introductionmentioning

confidence: 99%

Hepatic and renal mechanisms underlying the osmopressor response

Garland

Diedrich

et al. 2017

Autonomic Neuroscience

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Increased blood pressure (BP) is observed in patients with impaired baroreflexes after water drinking. The stimulus for this effect is low blood osmolality, and it has been termed the osmopressor response (OPR). The BP increase is associated with activation of the sympathetic nervous system and a requirement for transient receptor potential vanilloid 4 (TRPV4) channels. However, the mechanisms underlying the OPR are poorly understood. We tested the hypothesis that hypotonicity is sensed in the portal area to initiate the OPR. Sino-aortic denervated mice were used and BP was monitored for 30 min after fluid infusion while mice were under anesthesia. Infusion of hypotonic fluid (0.45% saline), but not of isotonic 0.9% saline, directly into the portal vein, produced an immediate OPR (increase in BP with saline 0.45%: 15 ± 13 vs. 0.9%: −7 ± 2 mm Hg, p = 0.003; AUC: 0.45%: 150 ± 99, n = 7 vs. 0.9%: −74 ± 60 mm Hg · min, n = 5, p = 0.003). However, 0.45% saline was not able to trigger a similar response in TRPV4−/− mice (ΔBPTRPV4: −2 ± 5 mm Hg, n = 8, p = 0.009). Hypotonic saline did not raise BP when infused at the same speed and volume into the jugular vein (jugular: −5 ± 6 mm Hg, p = 0.002, compared to portal). Denervation of the splanchnic nerve by celiac ganglionectomy (CGX) did not abolish the OPR (CGX: 15 ± 11 vs. Sham: 16 ± 6 mm Hg, p = 0.34). Renal denervation diminished the OPR elicited by duodenal water infusion (denervation: 9 ± 4 vs. sham: 31 ± 15 mm Hg, p = 0.016). Therefore, hypotonicity in the portal circulation, probably sensed by TRPV4 channels, triggers the OPR and intact renal nerves are needed for the full response.

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“…A high sympathetic tone, however, rather lowers glomerular filtration rate and renal blood flow and is thus not a plausible, connecting mechanism (48). Endocrine agents that influence both BAT and kidney activity are therefore more fitting candidates.…”

Section: Discussionmentioning

confidence: 99%

Active Brown Fat During ¹⁸F-FDG PET/CT Imaging Defines a Patient Group with Characteristic Traits and an Increased Probability of Brown Fat Redetection

et al. 2017

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Brown adipose tissue (BAT) provides a means of nonshivering thermogenesis. In humans, active BAT can be visualized by 18 F-FDG uptake as detected by PET combined with CT. The retrospective analysis of clinical scans is a valuable source to identify anthropometric parameters that influence BAT mass and activity and thus the potential efficacy of envisioned drugs targeting this tissue to treat metabolic disease. Methods: We analyzed 2,854 18 F-FDG PET/CT scans from 1,644 patients and identified 98 scans from 81 patients with active BAT. We quantified the volume of active BAT depots (mean values in mL 6 SD: total BAT, 162 6 183 [n 5 98]; cervical, 40 6 37 [n 5 53]; supraclavicular, 66 6 68 [n 5 71]; paravertebral, 51 6 53 [n 5 69]; mediastinal, 43 6 40 [n 5 51]; subphrenic, 21 6 21 [n 5 29]). Because only active BAT is detectable by 18 F-FDG uptake, these numbers underestimate the total amount of BAT. Considering only 32 scans of the highest activity as categorized by a visual scoring strategy, we determined a mean total BAT volume of 308 6 208 mL. In 30 BAT-positive patients with 3 or more repeated scans, we calculated a much higher mean probability to redetect active BAT (52% 6 25%) as compared with the overall prevalence of 4.9%. We calculated a BAT activity index (BFI) based on volume and intensity of individual BAT depots. Results: We detected higher total BFI in younger patients (P 5 0.009), whereas sex, body mass index, height, mass, outdoor temperature, and blood parameters did not affect total or depotspecific BAT activity. Surprisingly, renal creatinine clearance as estimated from mass, age, and plasma creatinine was a significant predictor of BFI on the total (P 5 0.005) as well as on the level of several individual depots. In summary, we detected a high amount of more than 300 mL of BAT tissue. Conclusion: BAT-positive patients represent a group with a higher than usual probability to activate BAT during a scan. Estimated renal creatinine clearance correlated with the extent of activated BAT in a given scan. These data imply an efficacy of drugs targeting BAT to treat metabolic disease that is at the same time higher and subject to a larger individual variation than previously assumed.

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Autonomic regulation of kidney function

Cited by 13 publications

References 56 publications

Association between 24-hour blood pressure variability and chronic kidney disease: a cross-sectional analysis of African Americans participating in the Jackson heart study

Association between 24-hour blood pressure variability and chronic kidney disease: a cross-sectional analysis of African Americans participating in the Jackson heart study

Hepatic and renal mechanisms underlying the osmopressor response

Active Brown Fat During ¹⁸F-FDG PET/CT Imaging Defines a Patient Group with Characteristic Traits and an Increased Probability of Brown Fat Redetection

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Autonomic regulation of kidney function

Cited by 13 publications

References 56 publications

Association between 24-hour blood pressure variability and chronic kidney disease: a cross-sectional analysis of African Americans participating in the Jackson heart study

Association between 24-hour blood pressure variability and chronic kidney disease: a cross-sectional analysis of African Americans participating in the Jackson heart study

Hepatic and renal mechanisms underlying the osmopressor response

Active Brown Fat During 18F-FDG PET/CT Imaging Defines a Patient Group with Characteristic Traits and an Increased Probability of Brown Fat Redetection

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Active Brown Fat During ¹⁸F-FDG PET/CT Imaging Defines a Patient Group with Characteristic Traits and an Increased Probability of Brown Fat Redetection