Role of renal sensory nerves in physiological and pathophysiological conditions

被引:140
作者
Kopp, Ulla C. [1 ,2 ]
机构
[1] Univ Iowa, Carver Coll Med, Dept Internal Med, Iowa City, IA 52242 USA
[2] Univ Iowa, Carver Coll Med, Dept Pharmacol, Iowa City, IA 52242 USA
基金
美国国家卫生研究院;
关键词
kidney; renal denervation; renal mechanosensory nerves; hypertension; angiotensin; substance P; prostaglandin E-2; SALT-SENSITIVE HYPERTENSION; GENE-RELATED PEPTIDE; SUBSTANCE-P RELEASE; TREATMENT-RESISTANT HYPERTENSION; PROSTAGLANDIN-DEPENDENT RELEASE; IMPAIRED RENORENAL REFLEXES; ENDOGENOUS ANGIOTENSIN-II; PROTEIN-KINASE-C; RAT-KIDNEY; SYMPATHETIC DENERVATION;
D O I
10.1152/ajpregu.00351.2014
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Whether activation of afferent renal nerves contributes to the regulation of arterial pressure and sodium balance has been long overlooked. In normotensive rats, activating renal mechanosensory nerves decrease efferent renal sympathetic nerve activity (ERSNA) and increase urinary sodium excretion, an inhibitory renorenal reflex. There is an interaction between efferent and afferent renal nerves, whereby increases in ERSNA increase afferent renal nerve activity (ARNA), leading to decreases in ERSNA by activation of the renorenal reflexes to maintain low ERSNA to minimize sodium retention. High-sodium diet enhances the responsiveness of the renal sensory nerves, while low dietary sodium reduces the responsiveness of the renal sensory nerves, thus producing physiologically appropriate responses to maintain sodium balance. Increased renal ANG II reduces the responsiveness of the renal sensory nerves in physiological and pathophysiological conditions, including hypertension, congestive heart failure, and ischemia-induced acute renal failure. Impairment of inhibitory renorenal reflexes in these pathological states would contribute to the hypertension and sodium retention. When the inhibitory renorenal reflexes are suppressed, excitatory reflexes may prevail. Renal denervation reduces arterial pressure in experimental hypertension and in treatment-resistant hypertensive patients. The fall in arterial pressure is associated with a fall in muscle sympathetic nerve activity, suggesting that increased ARNA contributes to increased arterial pressure in these patients. Although removal of both renal sympathetic and afferent renal sensory nerves most likely contributes to the arterial pressure reduction initially, additional mechanisms may be involved in long-term arterial pressure reduction since sympathetic and sensory nerves reinnervate renal tissue in a similar time-dependent fashion following renal denervation.
引用
收藏
页码:R79 / R95
页数:17
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