Reflex activation of renal nerves in humans: differential effects on noradrenaline, dopamine and renin overflow to renal venous plasma.

Abstract

Using a thermodilution technique for renal venous blood flow measurements, renal sympathetic nerve activity was evaluated in 10 healthy volunteers by measurements of noradrenaline (NA) and dopamine (DA) overflow to renal venous plasma. Renin release was measured simultaneously. At rest, arterial adrenaline (ADR) levels were 0.24 +/- 0.03 nmol-1 and NA and DA levels were higher in renal venous than in arterial plasma (1.24 vs. 0.98 and 0.14 vs. 0.09 nmol l-1, respectively, P less than 0.01 for both). The renal extraction of ADR from arterial plasma was 40 +/- 4%. ADR extractions were used to correct for the renal removal of NA or DA from arterial plasma when calculating the renal overflow of NA or DA to renal venous plasma. At rest, the thus corrected renal venous overflows of NA and DA were 228 +/- 34 and 29 +/- 3 pmol min-1, respectively. Isometric handgrip exercise (IHG) increased renal vascular resistance (RVR) by 20% and NA overflow by 123%, without altering renin release or DA overflow. Vasodilatation induced by dihydralazine (HYDR) increased NA overflow by 63% (P less than 0.05) and elevated DA overflow by 107 +/- 59%. The renal DA/NA overflow ratio was reduced from 0.15 to 0.06 (P less than 0.01) during IHG, but was not altered by HYDR. Renin release increased by 377% after HYDR (P less than 0.001) and was correlated to the reduction of mean arterial pressure but not changes in NA overflow. Thus, both IHG and HYDR increased renal sympathetic nerve activity, although differential effects on renin release and DA overflow were observed. The dissociation of renal NA and DA responses suggests that the human kidney may have a subset of dopaminergic nerves.