Crosstalk between the nervous system and the kidney
Open accessAbstract
Under physiological states, the nervous system and the kidneys communicate with each other to maintain normal body homeostasis. However, pathological states disrupt this interaction as seen in hypertension, and kidney damage can cause impaired renorenal reflex and sodium handling. In acute kidney injury (AKI) and chronic kidney disease (CKD), damaged kidneys can have a detrimental effect on the central nervous system. CKD is an independent risk factor for cerebrovascular disease and cognitive impairment, and many factors, including retention of uremic toxins and phosphate, have been proposed as CKD-specific factors responsible for structural and functional cerebral changes in patients with CKD. However, more studies are needed to determine the precise pathogenesis. Epidemiological studies have shown that AKI is associated with a subsequent risk for developing stroke and dementia. However, recent animal studies have shown that the renal nerve contributes to kidney inflammation and fibrosis, whereas activation of the cholinergic anti-inflammatory pathway, which involves the vagus nerve, the splenic nerve, and immune cells in the spleen, has a significant renoprotective effect. Therefore, elucidating mechanisms of communication between the nervous system and the kidney enables us not only to develop new strategies to ameliorate neurological conditions associated with kidney disease but also to design safe and effective clinical interventions for kidney disease, using the neural and neuroimmune control of kidney injury and disease.
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The kidneys are responsible for eliminating harmful circulating substances, preventing their excessive accumulation in the brain.
“The kidneys are responsible for eliminating harmful circulating substances, preventing their excessive accumulation in the brain.249”
From Antiageing strategy for neurodegenerative diseases: from mechanisms to clinical advances (2025) · cites this paper as [249]
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- Authors
- Tanaka, S., & Okusa, M. D.
- Affiliations
- University of Virginia (US)
- Corresponding author
- Okusa, Mark D.
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 97
- Issue
- 3
- Pages
- 466-476
- ISSN
- 0085-2538 (ISSN-L)
- PMC
- PMC7039752
- OpenAlex
- W2991652756
- Cited by
- 160
- References
- 149
- Citations by year
- 2026: 29 · 2025: 38 · 2024: 33 · 2023: 14 · 2022: 21 · 2021: 18 · 2020: 5 · 2018: 2
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Kidney International (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Topics
- Life Sciences › Neuroscience › Neurology › Vagus Nerve Stimulation Research
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Keywords
- chronic kidney disease, acute kidney injury, uremic toxins, phosphate retention, cognitive impairment, cerebrovascular disease, dementia, stroke, renal nerves, cholinergic anti-inflammatory pathway, vagus nerve, splenic nerve, neuroinflammation, renal fibrosis, sodium handling, hypertension
- MeSH terms
- Animals, Fibrosis, Humans, Kidney, Nervous System, Reperfusion Injury, Renal Insufficiency, Chronic, Acute Kidney Injury
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