The Potential Role of Sympathetic Nerve Activity in the Development of Diabetic Nephropathy

Journal of Clinical and Basic Cardiology 2001; 4 (3): 183-185

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Keywords: Diabetes mellitus,  Kardiologie,  Nephropathie,  sympathisches Nervensystem,  cardiology,  Diabetes,  nephropathy,  sympathetic activity

Diabetic nephropathy is one of the direst complications of diabetes. Progress in medical science has led to introduction of adequate therapeutic methods that can significantly reduce the incidence of this complication, but cannot entirely prevent it. In the recent period much attention was dedicated to the role of excessive activation of the sympathetic nervous system (SNS) in pathogenesis of kidney diseases. The results of experimental and clinical studies reveal that renal affect is associated with increased activity of the SNS, which may lead to progressive multiorgan injury. However, application of drugs inhibiting the activity of the SNS results in lowering of the rate of development of systemic lesions and progression of the glomerulopathy. Preliminary clinical data show that application of moxonidine, SNS inhibitor, in non-hypotensive doses in normotensive patients with type 1 diabetes and microalbuminuria results in decrease of urinary albumin excretion. Non-hypotensive effect of moxonidine, leading to decrease in the progression of diabetic nephropathy, should be confirmed in large clinical trials. Administration of SNS-inhibiting drugs may then become a new therapeutic option in prevention of microangiopathic diabetic complications.