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Titolo:
Sympathetic nervous system and chronic renal failure
Autore:
Boero, R; Pignataro, A; Ferro, M; Quarello, F;
Indirizzi:
Osped G Bosco, Div Nefrol & Dialisi, I-10154 Turin, Italy Osped G Bosco Turin Italy I-10154 Nefrol & Dialisi, I-10154 Turin, Italy
Titolo Testata:
CLINICAL AND EXPERIMENTAL HYPERTENSION
fascicolo: 1-2, volume: 23, anno: 2001,
pagine: 69 - 75
SICI:
1064-1963(200101/02)23:1-2<69:SNSACR>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
AFFERENT DENERVATION PREVENTS; BLOOD-PRESSURE PATTERN; NITRIC-OXIDE SYNTHASE; NEUROGENIC CONTROL; HYPERTENSION; DISEASE; HEMODIALYSIS; RATS; HYPOTENSION; KIDNEY;
Keywords:
sympathetic nervous system; chronic renal failure; hypertension; cardiovascular mortality; dialysis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Boero, R Osped G Bosco, Div Nefrol & Dialisi, Piazza Donatore Sangue 3, I-10154 Turin, Italy Osped G Bosco Piazza Donatore Sangue 3 Turin Italy I-10154 Italy
Citazione:
R. Boero et al., "Sympathetic nervous system and chronic renal failure", CLIN EXP HY, 23(1-2), 2001, pp. 69-75

Abstract

The aim of this work was to review evidence on the role of the sympatheticnervous system (SNS) in chronic renal failure (CRF). Three main points arediscussed: 1) SNS and pathogenesis of arterial hypertension; 2) SNS and cardiovascular risk; 3) implication of SNS in arterial hypotension during hemodialysis. Several lines of evidence indicate the presence of a sympathetichyperactivity in CRF, and its relationship with arterial hypertension. It is suggested that diseased kidneys send afferent nervous signals to centralintegrative sympathetic nuclei, thus contributing to the development and maintenance of arterial hypertension. The elimination of these impulses with nephrectomy could explain the concomitant reduction of blood pressure. Several experiments confirmed this hypothesis. Regarding SNS and cardiovascular risk, some data suggest that reduced heart rate variability identifies an increased risk for both all causes and sudden death, independently from other recognized risk factors. Symptomatic hypotension is a common problem during hemodialysis treatment, occurring in approximately 20-30% of all hemodialysis sessions and is accompanied by acute withdrawal of sympathetic activity, vasodilation and relative bradicardia. This reflex is thought to be evoked by vigorous contraction of a progressively empty left ventricle, activating cardiac mechanoceptors. This inhibits cardiovascular centers through vagal afferents, and overrides the stimulation by baroreceptor deactivation. Alternative explanations include cerebral ischemia and increased production of nitric oxide, which inhibit central sympathetic activity. It is hoped that therapies aimed at modulatingsympathetic nerve activity in patients with CRF will ameliorate their prognosis and quality of life.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 07:01:25