Journal
KIDNEY INTERNATIONAL SUPPLEMENTS
Volume 1, Issue 1, Pages 13-16Publisher
ELSEVIER SCIENCE INC
DOI: 10.1038/kisup.2011.3
Keywords
chronic kidney disease; hypertension; renin angiotensin; sympathetic activity
Categories
Funding
- Abbott Laboratories
- F. Hoffmann-La Roche
- Amgen
- Fresenius Medical Care Holdings
- Roche Spain
- Abbott Spain
- Spanish Government
- Janssen-Cileg
- Astellas Pharma
- EU
- Shire
- Genzyme
- Novartis AG
- Sandoz
- Pfizer
- Baxter
- Medtronic
- Ardian
- Merck
- Affymax
- Takeda Pharmaceutical Company
- Daiichi Sankyo
- Celgene
- Watson Pharmaceuticals
- Rockwell Medical
- Medscape
- FMC
- Merck Sharp Dohme
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Chronic kidney disease is often characterized by enhanced activity of the renin-angiotensin system (RAS) and the sympathetic nervous system. Independent of their effect on blood pressure, these systems also contribute to the pathogenesis of both structural and functional cardiovascular abnormalities and contribute importantly to clinical outcome. There is much evidence that the diseased kidneys are of central importance in the pathogenesis of both abnormalities. Inhibitors of the RAS also reduce sympathetic overactivity. Future research should be aimed at addressing the pathophysiological mechanisms causing the enhanced activities. Given the fact that even a small kidney lesion can cause enhanced activity of the RAS and the sympathetic nervous system, it is likely that these pathophysiological mechanisms are operational in more disease conditions, including essential hypertension, heart failure, and obesity/metabolic syndrome.
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