慢性肾脏病继发的交感神经激活：肾脏去神经支配的治疗靶点？
Sympathetic activation secondary to chronic kidney disease: therapeutic target for renal denervation?
作者信息
de Beus Esther, de Jager Rosa, Joles Jaap A, Grassi Guido, Blankestijn Peter J
机构信息
aDepartment of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands bDepartment of Health Sciences, University of Milano-Bicocca cIRCCS Multimedica, Sesto San Giovanni, Milan, Italy *Esther de Beus and Rosa de Jager contributed equally to the manuscript.
出版信息
J Hypertens. 2014 Sep;32(9):1751-61. doi: 10.1097/HJH.0000000000000210.
Percutaneous ablation of the renal nerves [renal denervation (RDN)] has recently become available for treatment of (therapy-resistant) hypertension. In this review, the potential importance of RDN for patients with chronic kidney disease (CKD) is discussed. An overview of the role of the renal nerves is given, and the role of the kidneys as both generators and recipients of sympathetic hyperactivity is described. The clinical relevance of increased sympathetic nervous system activity in CKD is reviewed, and the effects of conventional treatment on sympathetic hyperactivity are summarized. Next, we present the current knowledge on the effect of RDN in CKD from both experimental and clinical studies. Finally, we discuss how this knowledge may help us in predicting the effect of RDN in hypertensive patients and ways to monitor the effect of the procedure itself.
经皮肾神经消融术[肾去神经支配术（RDN）]最近已可用于治疗（难治性）高血压。在本综述中，讨论了RDN对慢性肾脏病（CKD）患者的潜在重要性。概述了肾神经的作用，并描述了肾脏作为交感神经过度活跃的产生者和接受者的作用。综述了CKD中交感神经系统活动增加的临床相关性，并总结了传统治疗对交感神经过度活跃的影响。接下来，我们介绍来自实验和临床研究的关于RDN在CKD中作用的当前知识。最后，我们讨论这些知识如何帮助我们预测RDN对高血压患者的疗效以及监测该手术本身疗效的方法。
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