Reduced Renal Mass, Salt-Sensitive Hypertension Is Resistant to Renal Denervation

Frontiers in Physiology
Ionut TudoranceaRadu Iliescu

Abstract

Aim: Activation of the sympathetic nervous system is common in resistant hypertension (RHT) and also in chronic kidney disease (CKD), a prevalent condition among resistant hypertensives. However, renal nerve ablation lowers blood pressure (BP) only in some patients with RHT. The influence of loss of nephrons per se on the antihypertensive response to renal denervation (RDNx) is unclear and was the focus of this study. Methods: Systemic hemodynamics and sympathetically mediated low frequency oscillations of systolic BP were determined continuously from telemetrically acquired BP recordings in rats before and after surgical excision of ∼80% of renal mass and subsequent RDNx. Results: After reduction of renal mass, rats fed a high salt (HS) diet showed sustained increases in mean arterial pressure (108 ± 3 mmHg to 128 ± 2 mmHg) and suppression of estimated sympathetic activity (∼15%), responses that did not occur with HS before renal ablation. After denervation of the remnant kidney, arterial pressure fell (to 104 ± 4 mmHg), estimated sympathetic activity and heart rate (HR) increased concomitantly, but these changes gradually returned to pre-denervation levels over 2 weeks of follow up. Subsequently, sympathoinhibition with cloni...Continue Reading

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Citations

Mar 29, 2019·Circulation Research·Thomas E Lohmeier, John E Hall
Jan 15, 2020·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Norihiko MorisawaAkira Nishiyama
Jan 14, 2020·Physiological Research·L NalosJ Kuncová
Dec 24, 2019·Frontiers in Neuroscience·Alexandra E Soto-PiñaRandy Strong

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