Renal nerves in blood pressure regulation

Abstract

The observation that bilateral renal nerve ablation can reduce blood pressure represents an important therapeutic milestone. Nonetheless, questions arise as to the underlying mechanisms, the long-term consequences, whether there may be re-innervation over a number of years, or whether some unknown consequence to the denervation may arise. This may point to the development of novel compounds targeted to the innervation of the kidney.

Type 2 Diabetes Mellitus and Hypertension

“…Activation of renal sympathetic nerves plays an important role in the pathogenesis of HTN (119). Renal denervation (RDN) is a percutaneous catheter-based renal sympathetic denervation procedure to disrupt renal afferent and efferent nerves using radiofrequency ablation (120, 123, 124).…”

Obesity depresses baroreflex control of renal sympathetic nerve activity and heart rate in Sprague Dawley rats: role of the renal innervation

“…). The high‐ and low‐pressure baroreceptors represent one of the most potent afferent inputs which reflexly regulate sympathetic outflow that impacts not only on the cardiovascular system but also on the kidney to determine extracellular fluid volume (Johns & Abdulla ). Impaired baroreflex regulation of renal sympathetic nerve activity (RSNA) has been reported in both diet‐induced and genetically obese rats (Wong & Johns , Skrapari et al .…”

Renal Sympathetic Nerve-Derived Signaling in Acute and Chronic Kidney Diseases

“…Experimental studies demonstrated that renal denervation slowed or delayed the rise in BP in experimental models of hypertension such as spontaneous hypertension, salt-sensitive hypertension, Nω-nitro-L-arginine methyl ester (L-NAME) induced hypertension, Ang II induced hypertension and deoxycorticosterone acetate (DOCA)-salt hypertension [99][100][101][102][103][104][105]. Singh et al reported that the reduction in BP and albuminuria and improved GFR in sheep with hypertensive CKD, observed at 5 months after catheter-based RDNx, were sustained until 30 months after RDNx, demonstrating the long-term durability of the beneficial effects of RDNx in hypertensive CKD [106].…”