The Cardiorenal Cross Talk

The Autonomic Pathway Regulating the Cardiocirculatory Balance
  • Edoardo GrondaEmail author
  • Emilio Vanoli
Living reference work entry


The autonomic nervous system (ANS) controls essential physiologic functions, including heart rate, blood pressure, and body fluid volume regulation [1]. It is now well understood that the ANS is specifically designed to maintain body homeostasis eliciting organ-specific responses in the face of external challenges [2]. This complex task is accomplished by continuous and instantaneous interactions of its two limbs: the sympathetic and parasympathetic ones. As a matter of fact, the so-called sympatho-vagal interaction is the key mechanism able to warrant all needed adjustments to any aspect of the physiological activity of the entire body. Any alteration or maladaptive response of the ANS to physiological or pathological events (from simple position changes to compensatory responses to acute myocardial ischemia, for instance) results in disease development or progression. Specific to the cardio-renal axis is the fact that congestion due to intravascular overload is the most potent driver of sympathetic nervous system activation that increases arterial vascular resistance and organ hypoperfusion. In this context, kidneys are severely blood supply deprived and react to the higher intra-parenchimal vascular resistance by increasing the sympathetic response and the neuro-hormonal activation, with major consequence in fluid retention. The overall effect worsens heart function and target organs damage contributing to maintain and to aggravate heart failure progression.


Cardio-renal axis Heart failure Autonomic nervous system 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Dept Medicina e Specialità Mediche – Nephrology SectionIRCCS Cà Granda Policlinico di MilanoMilanItaly
  2. 2.Department of Molecular MedicineUniversity of PaviaPaviaItaly
  3. 3.Cardiovascular Department IRCCS MultiMedicaSesto San GiovanniItaly

Section editors and affiliations

  • Alessia Pascale
    • 1
  • Emilia d’Elia
    • 2
  1. 1.Department of Drug Sciences, Section of PharmacologyUniversity of PaviaPaviaItaly
  2. 2.Dipartimento CardiovascolareAzienda Ospedaliera Papa Giovanni XXIIIBergamoItaly

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