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Kidney and hypertension: is there a place for renalase?
Edyta Zbroch1, Jolanta Małyszko, Jacek Małyszko
1Department of Nephrology and Transplantology, Medical University of Bialystok, Białystok, Poland. edzbroch@poczta.onet.pl
Insights
Chronic kidney disease (CKD) patients often have hypertension due to increased sympathetic activity. Lower levels of the protein renalase, which degrades catecholamines, may contribute to this condition.
Area of Science:
- Nephrology
- Cardiology
- Biochemistry
Background:
- Hypertension is prevalent in Chronic Kidney Disease (CKD), affecting 80-85% of patients.
- Enhanced sympathetic nervous system activity and reduced catecholamine clearance contribute to elevated blood pressure in CKD.
- Renalase, a newly discovered protein, degrades catecholamines and may influence hemodynamic function.
Purpose of the Study:
- To investigate the role of renalase in the pathogenesis of hypertension in Chronic Kidney Disease (CKD).
- To explore the association between renalase levels and hypertension in CKD patients.
Main Methods:
- Review of existing literature on renalase, catecholamines, and hypertension in CKD.
- Analysis of studies reporting serum renalase levels in CKD and hemodialysis patients compared to healthy individuals.
Main Results:
- Studies indicate lower serum renalase levels in CKD and hemodialysis patients compared to healthy controls.
- Conflicting reports exist, with some studies showing increased renalase levels in dialysis patients and kidney transplant recipients.
- Data linking renalase gene expression, activity, and concentration to its function in hypertension is currently lacking.
Conclusions:
- The precise role of renalase in CKD-associated hypertension requires further investigation.
- Future studies must establish whether renalase is actively involved in hypertension development or is merely an indicator.
- Clarifying renalase's function is crucial for understanding and potentially treating hypertension in CKD.
Abstract:
Chronic kidney disease (CKD) is associated with a considerably higher risk of cardiovascular disease due to the presence of traditional and nontraditional risk factors. Hypertension occurs in approximately 80% to 85% of the patients with CKD and its etiology is multifactorial. The sympathetic nervous system activity is enhanced in patients witch CKD resulting in increased vascular resistance and systemic blood pressure. This enhanced activity is the result of overspill and reduced catecholamine clearance. Recently, a new protein was discovered, named renalase. Experimental in vitro studies showed that renalase degrades catecholamines and thus may have a significant hemodynamic effect in vivo, for example may decrease cardiac contractility, heart rate, and blood pressure. Studies conducted in CKD and hemodialysis patients demonstrated lower serum renalase levels compared with healthy individuals. Other studies revealed increased serum renalase levels in dialysis population and kidney transplant recipients. There are no data concerning the association between renalase gene expression and activity/concentration and function of renalase; thus, it has to be proved in further studies that renalase is not an innocent bystander but is involved in the pathogenesis of hypertension.
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