Kidney neural diversity and blood pressure regulation: resolving controversies and guiding hypertension therapy.

The kidney receives innervation from 3 distinct neural populations: tyrosine hydroxylase-positive sympathetic nerves, acetylcholine-positive parasympathetic nerves, and calcitonin gene-related peptide (CGRP)-positive vagal sensory nerves. Activation of kidney parasympathetic nerves triggers acetylcholine release. Optogenetic activation of kidney vagal sensory neurons decreases blood pressure and heart rate, whereas selective activation of kidney parasympathetic nerves exerts no measurable impact on blood pressure and heart rate.