Neural Control of Renal Function
By Edward J Johns, Ulla C. Kopp, G. Dibona. Comprehensive Physiology, 2011
872 citations recorded by the source corpus.
The kidney is innervated with efferent sympathetic nerve fibers that directly contact the vasculature, the renal tubules, and the juxtaglomerular granular cells. Via specific adrenoceptors, increased efferent renal sympathetic nerve activity decreases renal blood flow and glomerular filtration rate, increases renal tubular sodium and water reabsorption, and increases renin release. Decreased efferent renal sympathetic nerve activity produces opposite functional responses. This integrated system contributes importantly to homeostatic regulation of sodium and water balance under physiological conditions and to pathological alterations in sodium and water balance in disease. The kidney contains afferent sensory nerve fibers that are located primarily in the renal pelvic wall where they sense stretch. Stretch activation of these afferent sensory nerve fibers elicits an inhibitory renorenal reflex response wherein the contralateral kidney exhibits a compensatory natriuresis and diuresis due to diminished efferent renal sympathetic nerve activity. The renorenal reflex coordinates the excretory function of the two kidneys so as to facilitate homeostatic regulation of sodium and water balance. There is a negative feedback loop in which efferent renal sympathetic nerve activity facilitates increases in afferent renal nerve activity that in turn inhibit efferent renal sympathetic nerve activity so as to avoid excess renal sodium retention. In states of renal disease or injury, there is activation of afferent sensory nerve fibers that are excitatory, leading to increased peripheral sympathetic nerve activity, vasoconstriction, and increased arterial pressure. Proof of principle studies in essential hypertensive patients demonstrate that renal denervation produces sustained decreases in arterial pressure. © 2011 American Physiological Society. Compr Physiol 1:731‐767, 2011.
Subfields: Cardiology and Cardiovascular Medicine, Endocrinology, Diabetes and Metabolism, Pharmacology
View Paper: https://www.semanticscholar.org/paper/5608d7334c5b54c6a2a355695edfe2c5199fce28
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In Cardiology and Cardiovascular Medicine
- Philippe van de Borne
- S. Laurent
- Paulus Kirchhof
- E. Schiffrin
- H. S. Boudier
- B. K. Pedersen
- B. Saltin
In Endocrinology, Diabetes and Metabolism
In Pharmacology
Citations in the corpus
- Thresholds for thermal damage to normal tissues: An update (2011, neutral): “nerve is considered a major cause of the pathophysiology of hypertension [26, 27].”
- 2013 ESH/ESC Guidelines for the management of arterial hypertension (2007, background): “The rationale for renal denervation lays in the importance of sympathetic influences on renal vascular resistance, renin release and sodium re-absorption, the increased sympathetic tone to the kidney and other organs displayed by hypertensive patients [622–624], and the pressor effect of renal affer”
- ESH / ESC Guidelines for the management of arterial hypertension (2013, background): “– 621 The rationale for renal denervation lays in the importance of sympathetic influences on renal vascular resistance, renin release and sodium reabsorption, the increased sympathetic tone to the kidney and other organs displayed by hypertensive patients,(622) – 624 and the pressor effect of renal”
- The 2015 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. (2013, background): “The rationale for renal denervation lays in the importance of sympathetic influences on renal vascular resistance, renin release and sodium re-absorption, the increased sympathetic tone to the kidney and other organs displayed by hypertensive patients [622–624], and the pressor effect of renal affer”