Exercise Pressor Reflex Function Is Exacerbated in Decerebrate Adenine-Induced Chronic Kidney Disease Rats
Authors: Kim Han-Kyul , Estrada Juan , Fukazawa Ayumi , Hori Amane , Iwamoto Gary , Mizuno Masaki , Smith Scott 
Published: May 2024

Cardiovascular disease is the leading cause of death in chronic kidney disease (CKD). While the underlying mechanisms are not completely understood, elevated sympathetic nerve activity (SNA) and exercise intolerance are thought to play an important role. In normal physiological conditions, sympathetic modulation of the cardiovascular system during physical activity is largely governed by a peripheral neural reflex originating in contracting skeletal muscle, known as the exercise pressor reflex (EPR). Pioneering work by Park et al. demonstrated that CKD patients exhibited abnormal SNA and blood pressure (BP) elevations during both static and rhythmic handgrip exercise, suggesting an overactive EPR. However, due to experimental design constraints inherent to humans, the contribution of the EPR to the augmented SNA and BP responses to exercise could not be fully addressed. Therefore, the purpose of this study was to specifically test EPR function in CKD using a reduced animal model. Sprague-Dawley rats were randomly assigned to receive either a powdered chow diet containing adenine (0.25%w/w in feed) to induce CKD or a powdered chow diet alone (control group) for 12 weeks. Subsequently, in decerbrate animals, we measured mean arterial pressure (MAP) and renal SNA (RSNA) in response to isolated EPR activation during hindlimb muscle contraction (i.e., simulated exercise). We further assessed cardiovascular and sympathetic responses to passive muscle stretch to stimulate the mechanoreflex (i.e., activation of the mechanically-sesnsitive component of the EPR), and intra-arterial capsaicin administratration to activate the metaboflex (i.e., stimulation of the metabolically-sensitive component of the EPR). After completion of the diet, levels of plasma creatinine were significantly increased in adenine-fed rats compared to control rats (2.57±1.05 vs. 0.34±0.05 mg/dL, P<0.01), suggesting impaired renal function (i.e., adenine-induced CKD). We found that CKD animals exhibited augmentations in RSNA (Δ=153±75 vs. 61±50 %, P<0.05) and MAP (Δ=35±18 vs. 17±8 mmHg, P<0.05) in response to muscle contraction when compared to control animals. Importantly, the muscle tension developed during contraction was similar between the two groups (Δ=0.9±0.2 vs. 1.0±0.3 kg, P>0.1, CKD vs. control). During stimulation of the mechanoreflex, CKD rats also exhibited significantly greater RSNA (Δ=100±54 vs. 32±26 %, P<0.05) and MAP responses (Δ=25±14 vs. 10±7 mmHg, P<0.05) than control rats. The developed muscle tension during passive stretch was similar between the two groups (Δ=0.9±0.2 vs. 1.0±0.4 kg, P>0.1, CKD vs. control). There was a tendency for the responses to metaboreflex activation to be heightened in the CKD group compared with the control group, but the difference did not reach statistical significance (ΔRSNA=212±68 vs. 107±105 %, P=0.06, ΔMAP=67±12 vs. 48±21 mmHg, P=0.06, CKD vs. control, respectively). Our findings suggest that EPR function, particularly muscle mechanoreflex function, is exaggerated in CKD, leading to sympathetic activation and hypertensive responses during exercise. P30 DK079307 Subaward to H.K. and R01HL-133179 to W.V. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.