Sympathetic overactivity in dialysis patients—Underappreciated and clinically consequential

Cardiovascular morbidity and mortality remain frustratingly common in dialysis patients. A dearth of established evidence‐based treatment calls for alternative therapeutic avenues to be embraced. Sympathetic hyperactivity, predominantly due to afferent nerve signaling from the diseased native kidney...

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Bibliographic Details
Published in:Seminars in dialysis 2019-05, Vol.32 (3), p.255-265
Main Authors: Hoye, Neil A., Wilson, Luke C., Jardine, David L., Walker, Robert J.
Format: Article
Language:English
Subjects:
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - physiopathology
Comorbidity
Global Health
Humans
Kidney - innervation
Kidney Failure, Chronic - epidemiology
Kidney Failure, Chronic - physiopathology
Kidney Failure, Chronic - therapy
Renal Dialysis - adverse effects
Risk Factors
Survival Rate
Sympathetic Nervous System - physiopathology
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Summary:Cardiovascular morbidity and mortality remain frustratingly common in dialysis patients. A dearth of established evidence‐based treatment calls for alternative therapeutic avenues to be embraced. Sympathetic hyperactivity, predominantly due to afferent nerve signaling from the diseased native kidneys, has been established to be prognostic in the dialysis population for over 15 years. Despite this, tangible therapeutic interventions have, to date, been unsuccessful and the outlook for patients remains poor. This narrative review summarizes established experimental and clinical data, highlighting recent developments, and proposes why interventions to ameliorate sympathetic hyperactivity may well be beneficial for this high‐risk population.
ISSN:0894-0959
1525-139X
DOI:10.1111/sdi.12756