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Cardiology Research and Practice
Volume 2012 (2012), Article ID 319432, 8 pages
http://dx.doi.org/10.1155/2012/319432
Review Article

Cardiovascular Risk in Chronic Kidney Disease: Role of the Sympathetic Nervous System

1Renal Division, Department of Medicine, Emory University School of Medicine, 1639 Pierce Drive, WMB 338, Atlanta, GA 30322, USA
2Research Service, Department of Veterans Affairs Medical Center, Decatur, GA 30033, USA

Received 19 May 2012; Accepted 24 June 2012

Academic Editor: Kazuko Masuo

Copyright © 2012 Jeanie Park. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients with chronic kidney disease are at significantly increased risk for cardiovascular disease and sudden cardiac death. One mechanism underlying increased cardiovascular risk in patients with renal failure includes overactivation of the sympathetic nervous system (SNS). Multiple human and animal studies have shown that central sympathetic outflow is chronically elevated in patients with both end-stage renal disease (ESRD) and chronic kidney disease (CKD). SNS overactivation, in turn, increases the risk of cardiovascular disease and sudden death by increasing arterial blood pressure, arrythmogenicity, left ventricular hypertrophy, and coronary vasoconstriction and contributes to the progression renal disease. This paper will examine the evidence for SNS overactivation in renal failure from both human and experimental studies and discuss mechanisms of SNS overactivity in CKD and therapeutic implications.