Renal nerves in physiology, pathophysiology and interoception

Area of Science:

• Nephrology
• Cardiology
• Hypertension Research

Background:

• Renal sympathetic nerves significantly influence kidney function and blood pressure regulation.
• Elevated renal sympathetic nerve activity is implicated in hypertension via sodium retention, renin release, and vasoconstriction.

Purpose of the Study:

• To investigate the therapeutic potential of selective afferent renal denervation (RDN) beyond traditional efferent nerve ablation.
• To explore the role of the kidney as an interoceptive organ in modulating sympathetic activity.

Main Methods:

• Review of existing research on renal denervation (RDN) techniques and their effects in animal models and clinical settings.
• Analysis of studies comparing selective afferent RDN with combined afferent-efferent RDN.

Main Results:

• Selective afferent RDN demonstrated comparable antihypertensive effects to combined RDN in animal models.
• Selective afferent RDN reduced sympathetic nerve activity and improved kidney function in chronic kidney disease models.
• Benefits of RDN extend to heart failure and arrhythmias, suggesting broader applications.

Conclusions:

• The kidney acts as an interoceptive organ, with sensory nerve activity influencing sympathetic output to other organs.
• Selective afferent RDN presents a potential therapeutic strategy for hypertension and other cardiorenal diseases associated with heightened sympathetic activity.
• Further research is needed to translate these findings into clinical practice for novel cardiorenal therapies.