Nephrol Dial Transplant (2000) 15: 1735-1738
© 2000 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Sympathetic overactivity in renal disease: a window to understand progression and cardiovascular complications of uraemia?
1 Universitätsklinik Freiburg, Innere Medizin IV, Freiburg, 2 Universitätsklinik Erlangen, Pathologisches Institut, Universität Erlangen, Erlangen and 3 Universitätsklinik Heidelberg, Nephrologie, Heidelberg, Germany
Keywords: chronic renal failure; sympathetic nervous system; hypertension
Introduction
Currently a dramatic increase in patients with end-stage renal failure is seen world-wide [1,2]. Furthermore, cardiovascular morbidity and mortality is exceedingly high in patients with chronic renal failure. Preventing progression of chronic renal failure and reducing cardiovascular complications in uraemia are major challenges to nephrologists. In the following we marshal evidence that sympathetic overactivity, so far a neglected aspect of renal failure, is an important pathomechanism contributing to progression and cardiovascular complications. It is possible that interventions to interfere with sympathetic overactivity will provide new therapeutic approaches.
The sympathetic nervous system in cardiovascular disease and chronic renal failure
In chronic renal disease, the two most important progression factors which are susceptible to intervention are hypertension and proteinuria. In this respect research and therapy in the past focused mainly on interventions concerning the renin-angiotensin-system. Many controlled studies have demonstrated that ACE-inhibitors, compared to placebo, attenuate the rate of progression of chronic renal failure. There is still
Renal disease activates the sympathetic system
Can one slow progression of renal failure by inhibiting sympathetic tone?
Notes
References
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