Published online before print September 23, 2002, doi: 10.1161/01.CIR.0000034043.16664.96
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2002;106:1974.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Sympathetic Nerve Activity in End-Stage Renal Disease
From the Department of Medicine D (M.H., M.K., P.H., M.B., H.H., K.K., K.H.R.) and the Department of Surgery (K.H.D.), University of Münster, Münster, Germany.
Correspondence to Martin Hausberg, MD, Department of Medicine D, University of Münster, Albert-Schweitzer-Strasse 33, D-48129 Münster, Germany. E-mail hausber{at}uni-muenster.de
Background— Uremia is proposed to increase sympathetic nerve activity (SNA) in hemodialysis patients. The aims of the present study were to determine whether reversal of uremia by successful kidney transplantation (RTX) eliminates the increased SNA and whether signals arising in the diseased kidneys contribute to the increased SNA in renal failure.
Methods and Results— We compared muscle sympathetic nerve activity (MSNA) in 13 hemodialysis patients wait-listed for RTX and in renal transplantation patients with excellent graft function treated with cyclosporine (RTX-CSA, n=13), tacrolimus (RTX-FK, n=13), or without calcineurin inhibitors (RTX-Ø, n=6), as well as in healthy volunteers (CON, n=15). In addition to the above patients with present diseased native kidneys, we studied 16 RTX patients who had undergone bilateral nephrectomy (RTX-NE). Data are mean±SEM. MSNA was significantly elevated in hemodialysis patients (43±4 bursts/min), RTX-CSA (44±5 bursts/min), RTX-FK (34±3 bursts/min), and RTX-Ø (44±5 bursts/min) as compared with CON (21±3 bursts/min), despite excellent graft function after RTX. RTX-NE had significantly reduced MSNA (20±3 bursts/min) when compared with RTX patients. MSNA did not change significantly with RTX in 4 hemodialysis patients studied before and after RTX (44±6 versus 43±5 bursts/min, P=NS). In contrast, nephrectomy resulted in reduced MSNA in all 6 RTX patients studied before and after removal of the second native kidney.
Conclusions— Despite correction of uremia, increased SNA is observed in renal transplant recipients with diseased native kidneys at a level not significantly different from chronic hemodialysis patients. The increased SNA seems to be mediated by signals arising in the native kidneys that are independent of circulating uremia related toxins.
Key Words: nervous system, sympathetic • kidney • kidney failure, chronic • cyclosporine • tacrolimus
This article has been cited by other articles:
 |
|
 |
|
  E. Ritz, H Krum, M Schlaich, R Whitbourn, P. Sobotka, J Sadowski, K Bartus, B Kapelak, A Walton, H Sievert, et al. New Approaches to Pathogenesis and Management of Hypertension Clin. J. Am. Soc. Nephrol., December 1, 2009; 4(12): 1886 - 1891. [Full Text] [PDF]
|
|
|
|
 |
|
 M. P. Schlaich, P. A. Sobotka, H. Krum, R. Whitbourn, A. Walton, and M. D. Esler Renal Denervation as a Therapeutic Approach for Hypertension: Novel Implications for an Old Concept Hypertension, December 1, 2009; 54(6): 1195 - 1201. [Full Text] [PDF]
|
|
|
|
 |
|
 I. Kesoi, B. Sagi, T. Vas, T. Kovacs, I. Wittmann, and J. Nagy Heart rate recovery after exercise is associated with renal function in patients with a homogenous chronic renal disease Nephrol. Dial. Transplant., September 25, 2009; (2009) gfp504v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Floras Sympathetic nervous system activation in human heart failure: clinical implications of an updated model. J. Am. Coll. Cardiol., July 28, 2009; 54(5): 375 - 385. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. P. Schlaich, F. Socratous, S. Hennebry, N. Eikelis, E. A. Lambert, N. Straznicky, M. D. Esler, and G. W. Lambert Sympathetic Activation in Chronic Renal Failure J. Am. Soc. Nephrol., May 1, 2009; 20(5): 933 - 939. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. K. Hothi, L. Rees, J. Marek, J. Burton, and C. W. McIntyre Pediatric Myocardial Stunning Underscores the Cardiac Toxicity of Conventional Hemodialysis Treatments Clin. J. Am. Soc. Nephrol., April 1, 2009; 4(4): 790 - 797. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Kalaitzidis and G. Bakris Should nephrologists use beta-blockers? A perspective Nephrol. Dial. Transplant., March 1, 2009; 24(3): 701 - 702. [Full Text] [PDF]
|
|
|
|
|
|
E. Ritz and C. Wanner The Challenge of Sudden Death in Dialysis Patients Clin. J. Am. Soc. Nephrol., May 1, 2008; 3(3): 920 - 929. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Li, J. Xu, P. Wang, H. Velazquez, Y. Li, Y. Wu, and G. V. Desir Catecholamines Regulate the Activity, Secretion, and Synthesis of Renalase Circulation, March 11, 2008; 117(10): 1277 - 1282. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. J. Blankestijn SYMPATHETIC HYPERACTIVITY--A HIDDEN ENEMY IN CHRONIC KIDNEY DISEASE PATIENTS Perit. Dial. Int., June 1, 2007; 27(Supplement_2): S293 - S297. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Boufi, P. Ghaffari, E. Allaire, H. Fessi, P. Ronco, and M. Vayssairat Foot Gangrene in Patients with End-Stage Renal Disease: A Case Control Study Angiology, May 1, 2006; 57(3): 355 - 361. [Abstract] [PDF]
|
|
|
|
|
|
R. T. Getts, S. M. Hazlett, S. B. Sharma, R. L. McGill, R. W. W. Biederman, R. J. Marcus, and S. E. Sandroni Regression of left ventricular hypertrophy after bilateral nephrectomy Nephrol. Dial. Transplant., April 1, 2006; 21(4): 1089 - 1091. [Full Text] [PDF]
|
|
|
|
|
|
X. J, L. G, W. P, V. H, Y. X, L. Y, W. Y, P. A, C. S, D. GV, et al. Kidney and Blood Pressure--The Story Unfolds: Renalase Is a Novel, Soluble Monoamine Oxidase That Regulates Cardiac Function and Blood Pressure. J Clin Invest J. Am. Soc. Nephrol., September 1, 2005; 16(9): 2521 - 2527. [Full Text] [PDF]
|
|
|
|
|
|
A. Ciarka, B. Najem, N. Cuylits, M. Leeman, O. Xhaet, K. Narkiewicz, M. Antoine, J.-P. Degaute, and P. van de Borne Effects of Peripheral Chemoreceptors Deactivation on Sympathetic Activity in Heart Transplant Recipients Hypertension, May 1, 2005; 45(5): 894 - 900. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Vonend, T. Apel, K. Amann, L. Sellin, J. Stegbauer, E. Ritz, and L. C. Rump Modulation of gene expression by moxonidine in rats with chronic renal failure Nephrol. Dial. Transplant., September 1, 2004; 19(9): 2217 - 2222. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C Mueller, F-J Neumann, A P Perruchoud, and H J Buettner Renal function and long term mortality after unstable angina/non-ST segment elevation myocardial infarction treated very early and predominantly with percutaneous coronary intervention Heart, August 1, 2004; 90(8): 902 - 907. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Kurata, A. Uehara, and A. Ishikawa Improvement of Cardiac Sympathetic Innervation by Renal Transplantation J. Nucl. Med., July 1, 2004; 45(7): 1114 - 1120. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Velez-Roa, J. Neubauer, M. Wissing, A. Porta, V. K. Somers, P. Unger, and P. van de Borne Acute arterio-venous fistula occlusion decreases sympathetic activity and improves baroreflex control in kidney transplanted patients Nephrol. Dial. Transplant., June 1, 2004; 19(6): 1606 - 1612. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Blankestijn Sympathetic hyperactivity in chronic kidney disease Nephrol. Dial. Transplant., June 1, 2004; 19(6): 1354 - 1357. [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. M. Zwanenburg, M. J. W. Gotte, J. P. A. Kuijer, R. M. Heethaar, A. C. van Rossum, and J. T. Marcus Timing of cardiac contraction in humans mapped by high-temporal-resolution MRI tagging: early onset and late peak of shortening in lateral wall Am J Physiol Heart Circ Physiol, May 1, 2004; 286(5): H1872 - H1880. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Joles and H. A. Koomans Causes and Consequences of Increased Sympathetic Activity in Renal Disease Hypertension, April 1, 2004; 43(4): 699 - 706. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. B. McCormick, A. Pierratos, S. Fenton, V. Jain, J. Zaltzman, and C. T. Chan Review of clinical outcomes in nocturnal haemodialysis patients after renal transplantation Nephrol. Dial. Transplant., March 1, 2004; 19(3): 714 - 719. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. A. Koomans, P. J. Blankestijn, and J. A. Joles Sympathetic Hyperactivity in Chronic Renal Failure: A Wake-up Call J. Am. Soc. Nephrol., March 1, 2004; 15(3): 524 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Grisk and R. Rettig Interactions between the sympathetic nervous system and the kidneys in arterial hypertension Cardiovasc Res, February 1, 2004; 61(2): 238 - 246. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. H.H.T. Klein, G. Ligtenberg, J. Neumann, P. L. Oey, H. A. Koomans, and P. J. Blankestijn Sympathetic Nerve Activity Is Inappropriately Increased in Chronic Renal Disease J. Am. Soc. Nephrol., December 1, 2003; 14(12): 3239 - 3244. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. T. Chan, P. J. Harvey, P. Picton, A. Pierratos, J. A. Miller, and J. S. Floras Short-Term Blood Pressure, Noradrenergic, and Vascular Effects of Nocturnal Home Hemodialysis Hypertension, November 1, 2003; 42(5): 925 - 931. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kosch, A. Levers, M. Fobker, M. Barenbrock, R. M. Schaefer, K.-H. Rahn, and M. Hausberg Dialysis filter type determines the acute effect of haemodialysis on endothelial function and oxidative stress Nephrol. Dial. Transplant., July 1, 2003; 18(7): 1370 - 1375. [Abstract] [Full Text] [PDF]
|
|