Afferent renal nerves and hypertension.

Adenosine-sensitive nerve endings have been found in the renal pelvis which when stimulated increase sympathetic activity producing hypertension. When urinary adenosine concentration is lowered by intrarenal infusion of adenosine deaminase in one-kidney one-clip rats, peripheral sympathetic nervous system activity and arterial pressure decrease if the renal nerves are intact. These data suggest that a stimulus for afferent renal nerve activity in one-kidney, one-clip hypertension is intrarenal adenosine. This intrarenal adenosine hypertensive reflex was examined further observing the responses to renal pelvic xylocaine infusion, selective renal deafferentation, adrenal demedullation and spinal cord transection (T6). The intrarenal adenosine hypertensive reflex was interrupted by renal pelvic xylocaine infusion, renal deafferentation and adrenal demedullation in normotensive and one-kidney, one-clip hypertensive animals. The intrarenal adenosine hypertensive reflex persisted after spinal cord transection (T6). These data support the concept that adenosine-sensitive intact afferent renal nerves located in the renal pelvis enhance sympathoadrenal activity resulting in the maintenance of one-kidney, one-clip hypertension and that this intrarenal adenosine-hypertensive response may occur as a spinal-level reflex in the rat.