Sympathetic overactivity and arterial hypertension in renal failure

In the past, it had been presumed that hypertension in chronic renal diseas e can be explained by the dual effects of sodium retention and inappropriat e activity of the renin-angiotensin system. Recent experimental and clinica l data provide strong evidence that the increase in blood pressure is to a large part due to sympathetic overactivity which is triggered by afferent s ignals emanating from the kidney and resetting sympathetic tone by stimulat ion of hypothalamic centres. The sequelae of sympathetic overactivity exten d beyond their effects on blood pressure and include accelerated progressio n of renal failure and presumably increased cardiac arrhythmia.