Department of Nephrology, University Medical Center Utrecht, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Curr Hypertens Rep. 2013 Apr;15(2):95-101. doi: 10.1007/s11906-013-0328-5.
Abundant evidence shows that chronic kidney disease (CKD) is a disease state characterized by increased sympathetic activation. Kidney injury (ischemia) plays a central role in this pathogenesis. Sympathetic excitation is associated with an increased risk of cardiovascular morbidity and mortality. Several pharmacologic strategies are developed to decrease sympathetic activity. However, these medications have limitations. Percutaneous catheter-based renal denervation has the potential to become a new treatment option for CKD. This current report focuses on the effects of sympathetic hyperactivity in CKD, and gives an overview in experimental as well as clinical evidence for a central role of the kidneys in the pathophysiology of sympathetic hyperactivity. Moreover, the effect of pharmacologic treatment and the potential beneficial effect of renal denervation will be discussed.
大量证据表明，慢性肾脏病（CKD）是一种以交感神经激活增加为特征的疾病状态。肾脏损伤（缺血）在这一发病机制中起着核心作用。交感兴奋与心血管发病率和死亡率的增加有关。已经开发出几种药物治疗策略来降低交感神经活性。然而，这些药物存在局限性。经皮导管肾去神经支配有可能成为 CKD 的一种新的治疗选择。本报告重点介绍 CKD 中交感神经活性过高的影响，并概述了肾脏在交感神经活性过高的病理生理学中的核心作用的实验和临床证据。此外，还将讨论药物治疗的效果和肾去神经支配的潜在有益效果。
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