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Unravelling kidney disease and its complications

Macquarie researchers are a step closer to determining the link that can cause patients with polycystic kidney disease (PKD) to die of heart failure.

PKD is a genetic disease that primarily affects the kidneys by causing fluid-filled cysts to develop in the kidneys, leading to chronic renal failure. However, cardiovascular disease is a common complication of PKD and researchers have long puzzled over the link between the two.

Professor Jacqueline Phillips and her team received a $15,000 grant from the recently established PKD Foundation to explore the role of the sympathetic nervous system, which is overactive in patients with PKD, in causing the development of heart disease.

“The sympathetic nervous system is responsible for the fright/flight/fight response while the parasympathetic nervous system is responsible for the rest/digest reflex,” explains Professor Phillips.

“In a healthy patient the two systems are in balance, but when the sympathetic nervous system dominates, as is the case with PKD patients, there can be side effects.

“One of these side effects is the increased release of noradrenaline at the heart, which may cause an elevated heart rate and impair the heart’s ability to respond quickly and appropriately to changes in blood pressure (the baroreflex).

“It can increase fibrous damage to the heart, and is known to cause an enlarged heart.”

Professor Phillips says that while they know that the brain is responsible for controlling the release of noradrenaline by the sympathetic nervous system, they don’t know why this might increase to the heart in patients with PKD. Her team is looking at noradrenaline receptors and chemical transporters around the heart, and whether or not they are contributing to the increase in sympathetic nervous system activity to the heart in PKD patients.

“We suspect that increased noradrenaline levels around the heart are evident before there is any obvious damage and in the long term being able to manage this may form part of treatment strategies.”

 

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