Sympathetic hyperactivity in end-stage renal disease

描述（由申请方提供）：心血管事件是终末期肾病（ESRD）患者的头号主要死亡原因。交感神经（SNS）活动增加可能导致这些患者的血压（BP）升高和心血管事件。在这项研究中测试的假设是，肌肉失调增加SNS活动在ESRD，有氧运动可能会改善SNS活动和血压在这些患者。将测试ESRD患者的异常骨骼肌反射激活，以确定该异常是否导致交感神经活动过度。具体而言，预期ESRD患者的代谢受体激活钝化和机械受体激活增强。如果ESRD患者的肌肉反射激活发生改变，运动训练可能会恢复代谢受体敏感性，并降低这些患者的机械感受器敏感性。在血液透析期间，将制定每周三次的短期运动方案，并测量这种干预对交感神经功能亢进和血压的影响。

DESCRIPTION (provided by applicant): Cardiovascular events are the number one leading cause of death in patients with end-stage renal disease (ESRD.) Increased sympathetic nerve (SNS) activity may contribute to raising blood pressure (BP) and cardiovascular events in these patients. The hypothesis tested in this study is that muscle deconditioning increases SNS activity in ESRD, and that aerobic exercise may improve SNS activity and BP in these patients. ESRD patients will be tested for abnormal skeletal muscle reflex activation to determine if this abnormality contributes to sympathetic hyperactivity. Specifically, blunting of metaboreceptor activation and augmentation of mechanoreceptor activation is expected in ESRD patients. If there is altered muscle reflex activation in patients with ESRD, exercise training may restore metaboreceptor sensitivity and decrease mechanoreceptor sensitivity in these patients. A short-term thrice weekly exercise regimen during hemodialysis will be instituted and the effects of this intervention on sympathetic hyperactivity and blood pressure will be measured.