Sympathetic nerve traffic overactivity seen in CKD patients

There appears to be a significantly higher microneurographic sympathetic nerve activity (MSNA) in patients with chronic kidney disease (CKD), independently of comorbidities, than in healthy individuals, which is associated with renal function, age, body mass index (BMI), and heart rate, reveals a study.

The investigators compared MSNA in CKD patients free of any cardiovascular complications (n=638) and healthy individuals (n=372). In addition, they evaluated the relationship of MSNA with the following factors: estimated glomerular filtration rate (eGFR), age, BMI, and haemodynamic variables.

Global analysis showed higher MSNA in CKD patients than in healthy control individuals (p<0.001). The difference in MSNA between the two cohorts was more pronounced in patients with end-stage kidney disease than in those with stage 3A or 3B CKD (p<0.001). Analysis combining patients and healthy individuals revealed a gradual increase in MSNA risk across progressively lower eGFR categories (p<0.01).

In separate meta-regression analyses in CKD patients and in healthy individuals, MSNA directly correlated with age (CKD: r, 0.57; p=0.022; healthy individuals: r, 0.71; p=0.031) and with BMI (CKD: r, 0.75; p=0.001; healthy individuals: r, 0.93; p=0.003). Additionally, MSNA was associated with heart rate (CKD: r, 0.77; p=0.02; healthy individuals: r, 0.66; p=0.01), but not with plasma norepinephrine.

“Sympathetic activation intensifies as CKD progresses toward kidney failure and such an intensification is paralleled by a progressive rise in heart rate, but it is not reflected by plasma norepinephrine,” the investigators said.