Jeanie Park, M.D., M.S.
Associate Professor, Division of Renal Medicine, Department of Medicine
Emory University School of Medicine
“Sympathetic regulation during exercise in chronic kidney disease”
Patients with chronic kidney disease (CKD) have impaired physical capacity and exercise intolerance that contribute to increased cardiovascular risk. This seminar will review hemodynamic and autonomic mechanisms that may contribute to exercise intolerance in this highly prevalent patient population. CKD is characterized by exaggerated increases in blood pressure during both isometric and rhythmic exercise, which could contribute to exercise dysfunction as well as increased risk of adverse cardiovascular events during physical activity. Augmented exercise pressor responses are in part due to exaggerated sympathetic nervous system (SNS) activation mediated by sensitization of the muscle mechanoreflex. In addition, CKD patients have an exaggerated increase in blood pressure for a given increase SNS activity, suggesting increased neurovascular transduction due to mechanisms such as impaired functional sympatholysis and heightened vascular adrenergic receptor sensitivity. Strategies to improve nitric oxide (NO) bioavailability, such as through exercise training or pharmacologic methods, may ameliorate exaggerated SNS and pressor responses during exercise in patients with CKD.
Friday, February 1, 2019, 11:00AM-12:00PM, LIB-110
University of North Texas Health Science Center
Fort Worth, Texas