Purpose: The present paper will review the impact of different therapeutic interventions on the autonomic dysfunction characterizing chronic renal failure. Methods: We reviewed the results of the studies carried out in the last few years examining the effects of standard pharmacologic treatment, hemodialysis, kidney transplantation, renal nerve ablation and carotid baroreceptor stimulation on parasympathetic and sympathetic control of the cardiovascular system in patients with renal failure. Results: Drugs acting on the renin–angiotensin system as well as central sympatholytic agents have been documented to improve autonomic cardiovascular control. This has also been shown for hemodialysis, although with more heterogeneous results related to the type of dialytic procedure adopted. Kidney transplantation, in contrast, particularly when performed together with the surgical removal of the native diseased kidneys, has been shown to cause profound sympathoinhibitory effects. Finally, a small amount of promising data are available on the potential favorable autonomic effects (particularly the sympathetic ones) of renal nerve ablation and carotid baroreceptor stimulation in chronic kidney disease. Conclusions: Further studies are needed to clarify several aspects of the autonomic responses to therapeutic interventions in chronic renal disease. These include (1) the potential to normalize sympathetic activity in uremic patients by the various therapeutic approaches and (2) the definition of the degree of sympathetic deactivation to be achieved during treatment.

Seravalle, G., Quarti-Trevano, F., Vanoli, J., Lovati, C., Grassi, G. (2021). Autonomic cardiovascular alterations as therapeutic targets in chronic kidney disease. CLINICAL AUTONOMIC RESEARCH, 31(4), 491-498 [10.1007/s10286-021-00786-6].

Autonomic cardiovascular alterations as therapeutic targets in chronic kidney disease

Seravalle G.
Primo
;
Quarti-Trevano F.
Secondo
;
Vanoli J.;Grassi G.
Ultimo
2021

Abstract

Purpose: The present paper will review the impact of different therapeutic interventions on the autonomic dysfunction characterizing chronic renal failure. Methods: We reviewed the results of the studies carried out in the last few years examining the effects of standard pharmacologic treatment, hemodialysis, kidney transplantation, renal nerve ablation and carotid baroreceptor stimulation on parasympathetic and sympathetic control of the cardiovascular system in patients with renal failure. Results: Drugs acting on the renin–angiotensin system as well as central sympatholytic agents have been documented to improve autonomic cardiovascular control. This has also been shown for hemodialysis, although with more heterogeneous results related to the type of dialytic procedure adopted. Kidney transplantation, in contrast, particularly when performed together with the surgical removal of the native diseased kidneys, has been shown to cause profound sympathoinhibitory effects. Finally, a small amount of promising data are available on the potential favorable autonomic effects (particularly the sympathetic ones) of renal nerve ablation and carotid baroreceptor stimulation in chronic kidney disease. Conclusions: Further studies are needed to clarify several aspects of the autonomic responses to therapeutic interventions in chronic renal disease. These include (1) the potential to normalize sympathetic activity in uremic patients by the various therapeutic approaches and (2) the definition of the degree of sympathetic deactivation to be achieved during treatment.
Articolo in rivista - Articolo scientifico
Autonomic nervous system; Carotid baroreceptor stimulation; Chronic renal failure; Dialysis; Kidney transplantation; Microneurography; Parasympathetic activity; Renal denervation; Sympathetic activity;
English
491
498
7
Seravalle, G., Quarti-Trevano, F., Vanoli, J., Lovati, C., Grassi, G. (2021). Autonomic cardiovascular alterations as therapeutic targets in chronic kidney disease. CLINICAL AUTONOMIC RESEARCH, 31(4), 491-498 [10.1007/s10286-021-00786-6].
Seravalle, G; Quarti-Trevano, F; Vanoli, J; Lovati, C; Grassi, G
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/356118
Citazioni
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
Social impact