[PP.09.14] SYMPATHETIC NERVOUS SYSTEM ACTIVITY, REFLECTED BY RENALASE AND CATECHOLAMINES, IN HYPERTENSIVE PATIENTS ACCORDING TO AGE AND PRESENCE OF CHRONIC KIDNEY DISEASE.

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Abstract

Objective:

Sympathetic nervous system activity is elevated in patients with chronic kidney disease as well as in elderly and contributes to hypertension and cardiovascular diseases. It is due to a reduction of catecholamines clearance from the blood and in elderly also to an increased sympathetic discharge directed to different organs. Renalase may play a role in the catecholamines degradation and in that way have the influence on blood pressure rate, heart and kidney function.

Design and method:

The aim of the study was to assess the sympathetic nervous system activity, according to serum renalase and catecholamines concentration in 211 hypertensive patients with or without chronic kidney disease required renal replacement therapy. The study group was divided dependently to age below and above 65 years. The older group (38%) was also divided into group with (75%) and without chronic kidney disease. The serum renalase, dopamine and norepinephrine concentration, blood pressure control, residual renal function and echocardiography were assessed.

Results:

The older group had elevated renalase and dopamine concentration comparing to younger and it was significantly higher in patients with chronic kidney disease. Elderly with chronic kidney disease also had the most advanced abnormalities in echocardiography, like left ventricular hyperthrophy and lower ejection fraction. They more often suffered from coronary artery disease. The residual renal function was less in older patients with chronic kidney disease. The main used hypotensive drugs in whole group were beta-blockers, elderly used calcium-channel blockers more often than angiotensin converting enzyme inhibitors. There was the significant correlation between age and renalase, norepinephrine and dopamine concentration.

Conclusions:

The advanced age of hypertensive patients especially combined with chronic kidney disease is associated with elevated renalase and dopamine level what is related to the sympathetic nervous system hyperactivity found here and it may have an impact on the development of cardiovascular complications as well as it appears to be the possible new marker of them in that special population.

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