Kaur M, Chandran DS, Jaryal AK, Bhowmik D, Agarwal SK, Deepak KK. Baroreflex dysfunction in chronic kidney disease. World J Nephrol 2016; 5(1): 53-65 [PMID: 26788464 DOI: 10.5527/wjn.v5.i1.53]
Corresponding Author of This Article
Ashok Kumar Jaryal, Professor of Physiology, Department of Physiology, All India Institute of Medical Sciences, Room No. 2009, Teaching block, Second floor, Ansari Nagar, New Delhi 110029, India. ashok.jaryal@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Manpreet Kaur, Dinu S Chandran, Ashok Kumar Jaryal, Kishore Kumar Deepak, Department of Physiology, All India Institute of Medical Sciences, New Delhi 110029, India
Dipankar Bhowmik, Sanjay Kumar Agarwal, Department of Nephrology, All India Institute of Medical Sciences, New Delhi 110029, India
Author contributions: Kaur M and Chandran DS performed the literature search and made the primary draft and draw the figures; Bhowmik D and Agarwal SK performed literature review and provided with clinical input about chronic kidney disease; Jaryal AK and Deepak KK suggested the theme to be reviewed and made the several critical corrections and revisions until the submitted version was achieved; Kaur M, Chandran DS, Jaryal AK and Deepak KK provided with the final draft of document.
Conflict-of-interest statement: The above-mentioned authors of this manuscript hereby declare that they do not have any conflict-of-interest (including but not limited to commercial, personal, political, intellectual, or religious interests) related to the work submitted herein.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ashok Kumar Jaryal, Professor of Physiology, Department of Physiology, All India Institute of Medical Sciences, Room No. 2009, Teaching block, Second floor, Ansari Nagar, New Delhi 110029, India. ashok.jaryal@gmail.com
Telephone: +91-90-13902960
Received: June 28, 2015 Peer-review started: July 13, 2015 First decision: September 17, 2015 Revised: November 5, 2015 Accepted: November 17, 2015 Article in press: November 25, 2015 Published online: January 6, 2016 Processing time: 192 Days and 0.6 Hours
Abstract
Chronic kidney disease (CKD) patients have high cardiovascular mortality and morbidity. The presence of traditional and CKD related risk factors results in exaggerated vascular calcification in these patients. Vascular calcification is associated with reduced large arterial compliance and thus impaired baroreflex sensitivity (BRS) resulting in augmented blood pressure (BP) variability and hampered BP regulation. Baroreflex plays a vital role in short term regulation of BP. This review discusses the normal baroreflex physiology, methods to assess baroreflex function, its determinants along with the prognostic significance of assessing BRS in CKD patients, available literature on BRS in CKD patients and the probable patho-physiology of baroreflex dysfunction in CKD.
Core tip: Cardiovascular dysfunction is an important complication and risk factor of mortality and morbidity in chronic kidney disease (CKD). Baroreflex is a functional integrator of cardiovascular homeostasis. Derangement in baroreflex function is not only a manifestation of cardiovascular pathogenesis in general and in CKD but also contribute to ongoing etio-pathogenesis. The present review discusses the physiology and dysfunction in CKD in light of the available literature.
