Nephrotic Proteinuria and the Autonomic Nervous System

Nephrotic proteinuria triggers off complex neuro-endocrine mechanisms where forebrain activation results in sympathetic over activity. An attempt is made to discuss and analyze the renal sympathetic efferent nerve hyperactivity, the role played by the angiotensin/nitric oxide system during proteinuria and the nitric oxide/angiotensin imbalance in the hypothalamus. Several questions arise: further experimental and clinical studies are necessary. The answers to these questions may disclose new clinical and therapeutic perspectives for the nephrotic syndrome.