ABSTRACT
There is clear evidence that chronic kidney disease [CKD] is often characterized by the presence of sympathetic hyperactivity. Data accumulating that this sympathetic hyperactivity is indeed important, because it may influence cardiovascular and renal prognosis. The aim of this study was to assess the relationship between glomerular filtration rate [GFR] and the levels of norepinephrine [NE] in serum and urine in the presence of variable degrees of renal functional impairment. A total of 75 CKD patients were divided into 5 groups according to GFR, group 1: 15 CKD patients with GFR>90ml/min/1.73m2 [stage 1CKD]. group 2: 15 CKD patients with GFR 60-89ml/min/1.73m2 [stage 2 CKD]. group 3: 15 CKD patients with GFR 30-59ml/min/1.73m2 [stage 3 CKD]. group 4: 15 CKD patients with GFR 15-29ml/min/1.73m2[stage 4 CKD]. group 5: 15 CKD patients with GFR<15ml/min/1.73m2 [stage 5, endstage renal failure], in addition to 15 healthy controls were studied. GFR was estimated by Cockroft-Gault formula. Norepinephrine was measured by an enzyme-linked immunosorbent assay. In addition, blood urea, serum creatinine, C-reactive protein [C-RP], fasting blood sugar [PBS], serum total cholesterol, triglycerides and 24-h urinary proteins were performed. Compared with controls, CKD patients had higher levels of serum norepinephrine, urinary norepinephrine was significantly lower among CKD patients. When GFR was reduced in CKD patients, serum norepinephrine was elevated and urinary norepinephrine was reduced suggesting greater renal impairment. In multivariate correlation, GFR were negatively correlated with serum norepinephrine and positively correlated with urinary norepinephrine. Serum norepinephrine levels were increased and urinary norepinephrine excretion were decreased in CKD patients, and may be one of the aggrevating factors for deterioration of renal function in those patients