Key result
Chronic renal failure was associated with greater muscle sympathetic nerve traffic than healthy controls (58.2 vs. 36.8 bursts/100 heart beats, P<0.01), while skin sympathetic traffic was similar.
Why the study?
Does mild-to-moderate chronic renal failure cause generalized or regionally confined sympathetic activation compared to healthy controls?
Case-Control (n=27)
Does mild-to-moderate chronic renal failure cause generalized or regionally confined sympathetic activation compared to healthy controls?
Absolute Event Rate: 58.2% vs 36.8%
p-value: p=<0.01
Sympathetic activation in mild-to-moderate chronic renal failure is regionally confined to muscle sympathetic nerve traffic rather than being generalized to the entire cardiovascular system.
May indicate selective sympathetic overdrive in renal failure; hypothesis-generating and requires prospective confirmation.
OBJECTIVES: Chronic renal failure is characterized by a marked sympathetic activation. No information exists, however, as to whether the adrenergic overdrive is confined to selected vascular districts or is rather generalized to the whole cardiovascular system. METHODS: In 15 patients aged 60.5 +/- 2.0 years (mean +/- SEM) with stable chronic renal failure belonging to stage 2-3 of the Kidney Foundation classification and in 12 age-matched healthy controls, we measured arterial blood pressure (Finapres), heart rate (ECG), venous plasma norepinephrine (high-performance liquid chromatography) and postganglionic sympathetic nerve traffic in skeletal muscle and skin areas (microneurography). Muscle and skin nerve traffic measurements were made in a randomized sequence over two periods of 30 min each, spaced by a 20-30-min interval. Measurements also included evaluation of skin sympathetic responses to emotional stimuli. RESULTS: Muscle sympathetic nerve traffic was markedly and significantly greater in renal failure patients compared with controls (58.2 +/- 3.6 vs. 36.8 +/- 5.7 bursts/100 heart beats, P < 0.01), with this also being the case for plasma norepinephrine (380.6 +/- 63 vs. 210.8 +/- 29 pg/ml, P < 0.05). By contrast, skin sympathetic nerve traffic was superimposable in the two groups (11.5 +/- 0.8 vs. 12.7 +/- 1.7 bursts/minute, P = not significant), this being the case also for the responses to emotional arousal. CONCLUSION: These data provide the first evidence that the sympathetic activation characterizing renal failure is not generalized to the entire cardiovascular system. This may depend on the fact that the two sympathetic districts are governed by mechanisms that are differently affected by the chronic uraemic state.
No takes yet. Share an insight, caveat, or question.
Grassı et al. (2009) conducted a case-control in Chronic renal failure (n=27). Chronic renal failure vs. Age-matched healthy controls was evaluated on Muscle sympathetic nerve traffic (bursts/100 heart beats) (p=<0.01). Chronic renal failure was associated with greater muscle sympathetic nerve traffic than healthy controls (58.2 vs. 36.8 bursts/100 heart beats, P<0.01), while skin sympathetic traffic was similar.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: