Neural Control of Renal Function*
Abstract
The renal nerves are the communication link between the central nervous system and the kidney. In response to multiple peripheral and central inputs, efferent renal sympathetic nerve activity is altered so as to convey information to the major structural and functional components of the kidney, the vessels, glomeruli, and tubules, each of which is innervated. At the level of each of these individual components, information transfer occurs via interaction of the neurotransmitter released at the sympathetic nerve terminal-neuroeffector junction with specific postjunctional receptors coupled to defined intracellular signaling and effector systems. In response to normal physiological stimuli, changes in efferent renal sympathetic nerve activity contribute importantly to homeostatic regulation of renal blood flow, glomerular filtration rate, renal tubular epithelial cell solute and water transport, and hormonal release. Afferent input from sensory receptors located in the kidney participates in this reflex control system via renorenal reflexes that enable total renal function to be self-regulated and balanced between the two kidneys. In pathophysiological conditions, abnormal regulation of efferent renal sympathetic nerve activity contributes significantly to the associated abnormalities of renal function which, in turn, are of importance in the pathogenesis of the disease.
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Renal sympathetic activation is central to the pathogenesis of essential hypertension.
“Renal sympathetic activation is thought to be central to the pathogenesis of essential hypertension94–96.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [95]
The renal sympathetic nerves, through their multiple influences on tubular processing of sodium, on renin secretion and on renal vascular resistance, with activation of the renal sympathetic outflow in essential hypertension as the driver, are pivotal in hypertension pathogenesis.
“The renal sympathetic nerves, through their multiple influences on tubular processing of sodium, on renin secretion and on renal vascular resistance94,95, with activation of the renal sympathetic outflow in essential hypertension as the driver, are pivotal in hypertension pathogenesis.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [95]
Renal sympathetic denervation shifts the renal pressure-natriuresis curve to the left, promoting urinary sodium excretion and lowering blood pressure.
“Renal sympathetic denervation shifts the renal pressure-natriuresis curve to the left, promoting urinary sodium excretion and lowering of blood pressure94–98.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [95]
Renal parenchymal nociceptive sensory nerves respond to a renal injury signal by projecting to the hypothalamus to increase central sympathetic outflow.
“The first, of the renal parenchyma and bearing nociceptive receptors, respond to a renal injury signal by projecting to the hypothalamus to increase central sympathetic outflow95–99.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [95]
Impairment of pressure natriuresis is believed to be a central element in the development of hypertension.
“Impairment of pressure natriuresis is believed to be a central element in the development of hypertension94,95,8.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [95]
Pressure-sensitive receptors in the renal pelvis are sympathoinhibitory and important in mediating reno-renal reflexes.
“The second are pressure-sensitive receptors in the renal pelvis; these are sympathoinhibitory and important in mediating reno-renal reflexes95.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [95]
Surgical sympathectomy in experimental hypertension abolishes the hypertension, or prevents its development.
“Surgical sympathectomy in experimental hypertension abolishes the hypertension, or prevents its development94–95.”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [95]
Three facts provided the knowledge base for the development of catheter-based renal denervation for treatment of essential hypertension: the presence of an activated renal sympathetic outflow in hypertensive patients, the blood-pressure lowering effect of surgical renal denervation in experimental models of hypertension, and the anatomy of the postganglionic renal sympathetic nerves in theirpassag
“Three facts provided the knowledge base for the development of catheter-based renal denervation for treatment of essential hypertension: 1) the presence of an activated renal sympathetic outflow in hypertensive patients, 2) the blood-pressure lowering effect of surgical renal denervation in experimental models of hypertension, and 3) the anatomy of the postganglionic renal sympathetic nerves in”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [95]
Renal denervation is invariably antihypertensive in four mammalian species (rats, dogs, rabbits, pigs).
“Why should renal denervation, in four mammalian species (rats, dogs, rabbits pigs) invariably be antihypertensive95–96”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [95]
Experimental surgical and catheter-based denervation for hypertension still works.
“Experimental surgical and catheter-based denervation for hypertension still works!”
From The Sympathetic Nervous System Alterations in Human Hypertension (2015) · cites this paper as [95]
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- Authors
- Kopp, U. C., & DiBona, G. F.
- Affiliations
- University of Iowa (US)
- ORCID
- DiBona, Gerald F.
- Venue
- Reflex Control of the Circulation
- Publisher
- CRC Press
- Published
- 2020-02-03
- Volume
- 77
- Issue
- 1
- Pages
- 493-528
- OpenAlex
- W2129695314
- Cited by
- 1,126
- References
- 2
- Citations by year
- 2025: 4 · 2024: 19 · 2023: 12 · 2022: 19 · 2021: 32 · 2020: 32 · 2019: 45 · 2018: 35 · 2017: 43 · 2016: 62 · 2015: 73 · 2014: 106 · 2013: 82 · 2012: 65
- FWCI
- 121.05
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- CRC Press eBooks (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p50hl044546-05, 5r01dk015843-26)
- National Heart, Lung, and Blood Institute (P50HL055006)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- renal sympathetic nerves, renal innervation, renal blood flow regulation, glomerular filtration rate, postjunctional receptors, renal homeostasis
- MeSH terms
- Animals, Kidney, Reflex, Renal Circulation, Sympathetic Nervous System
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