Catheter based renal denervation has recently been FDA approved for the treatment of hypertension. Traditionally, the anti-hypertensive effects of renal denervation have been attributed to the ablation of the efferent sympathetic renal nerves. In recent years the role of the afferent sensory renal nerves in the regulation of blood pressure has received increased attention. In addition, afferent renal denervation is associated with reductions in sympathetic nervous system activity. This suggests that reductions in sympathetic drive to organs other than the kidney may contribute to the non-renal beneficial effects observed in clinical trials of catheter based renal denervation. In this review we will provide an overview of the role of the afferent renal nerves in the regulation of renal function and the development of pathophysiologies, both renal and non-renal. We will also describe the central projections of the afferent renal nerves, to give context to the responses seen following their ablation and activation. Finally, we will discuss the emerging role of the kidney as an interoceptive organ. We will describe the potential role of the kidney in the regulation of interoceptive sensitivity and in this context, speculate on the possible pathological consequences of altered renal function.

中文翻译：

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健康和疾病中的肾内感受


基于导管的肾去神经术最近已被 FDA 批准用于治疗高血压。传统上，肾去神经支配的抗高血压作用归因于肾传出交感神经的消融。近年来，肾传入感觉神经在血压调节中的作用日益受到关注。此外，传入肾去神经支配与交感神经系统活动的减少有关。这表明对肾脏以外器官的交感神经驱动的减少可能有助于在基于导管的肾去神经术的临床试验中观察到的非肾脏有益效果。在这篇综述中，我们将概述传入肾神经在肾功能调节和肾和非肾病理生理学发展中的作用。我们还将描述传入肾神经的中央投射，以了解其消融和激活后所看到的反应。最后，我们将讨论肾脏作为内感受器官的新兴作用。我们将描述肾脏在调节内感受敏感性中的潜在作用，并在此背景下推测肾功能改变可能产生的病理后果。