{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:08:21Z","timestamp":1791547701944,"version":"4.3.4"},"reference-count":121,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>The autonomic nervous system plays a crucial role in regulating physiological processes and maintaining homeostasis through its two branches: the sympathetic nervous system and the parasympathetic nervous system. Dysregulation of the autonomic system, characterized by increased sympathetic activity and reduced parasympathetic tone, is a common feature in chronic kidney disease (CKD) and cardiovascular disease. This imbalance contributes to a pro-inflammatory state, exacerbating disease progression and increasing the risk for cardiovascular events. The sympathetic system promotes inflammation by releasing catecholamines, which activate adrenergic receptors on immune cells. The parasympathetic system exerts anti-inflammatory effects via the cholinergic anti-inflammatory pathway mediated by the vagus nerve. Targeting the autonomic system to restore the balance between the sympathetic and the parasympathetic components offers promising approaches to reduce inflammation and improve outcomes in CKD and cardiovascular disease. \u03b2-Blockers, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers are pharmacological agents that modulate sympathetic activity and have shown anti-inflammatory effects. Lifestyle interventions, such as a healthy diet, physical exercise, mindfulness, and meditation, enhance parasympathetic activity and improve autonomic function. Vagus nerve stimulation has emerged as a promising therapy, demonstrating significant potential in reducing inflammation and improving clinical outcomes in various conditions, including CKD, myocardial infarction, and stroke. Despite mixed results in heart failure trials, vagal nerve stimulation has consistently improved quality-of-life measures. Understanding the mechanisms underlying autonomic system regulation of inflammation can inform the development of novel therapeutic strategies to restore autonomic balance and improve patient outcomes in CKD and cardiovascular disease.<\/jats:p>","DOI":"10.1093\/ndt\/gfaf020","type":"journal-article","created":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T23:14:39Z","timestamp":1737846879000},"page":"1470-1482","source":"Crossref","is-referenced-by-count":37,"title":["The autonomic nervous system and inflammation in chronic kidney disease"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6616-1996","authenticated-orcid":false,"given":"Carmine","family":"Zoccali","sequence":"first","affiliation":[{"name":"Renal Research Institute , New York , NY ,","place":["USA"]},{"name":"Institute of Molecular Biology and Genetics (Biogem) , Ariano Irpino ,","place":["Italy"]},{"name":"Associazione Ipertensione Nefrologia Trapianto Renale (IPNET) , Reggio Calabria ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Mallamaci","sequence":"additional","affiliation":[{"name":"Divisione di Nefrologia e Trapianto Renale, Grande Ospedale Metropolitano , Reggio Calabria ,","place":["Italy"]},{"name":"CNR-IFC, Institute of Clinical Physiology, Research Unit of Clinical Epidemiology , Reggio Calabria ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Kanbay","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Koc University School of Medicine , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine R","family":"Tuttle","sequence":"additional","affiliation":[{"name":"Providence Medical Research Center, Providence Inland Northwest Health , Spokane, WA ,","place":["USA"]},{"name":"Nephrology Division and Kidney Research Institute, University of Washington School of Medicine , Seattle, WA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kotanko","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"De Caterina","sequence":"additional","affiliation":[{"name":"University of Pisa, and Division of Cardiology, Pisa University Hospital , Pisa ,","place":["Italy"]},{"name":"Universit\u00e9 de Lorraine, Inserm Clinical Investigation Center at Institut Lorrain du Coeur et des Vaisseaux, CHU Nancy , Nancy ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Grassi","sequence":"additional","affiliation":[{"name":"Clinica Medica, University Milano-Bicocca and University of Milano-Bicocca , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Mancia","sequence":"additional","affiliation":[{"name":"Clinica Medica, University Milano-Bicocca and University of Milano-Bicocca , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"2025080112221174300_bib1","doi-asserted-by":"publisher","first-page":"R89","DOI":"10.1088\/1361-6579\/aa6782","article-title":"An introduction into autonomic nervous function","volume":"38","author":"Karemaker","year":"2017","journal-title":"Physiol Meas"},{"key":"2025080112221174300_bib2","volume-title":"Anatomy, Autonomic Nervous System","author":"Waxenbaum","year":"2023"},{"key":"2025080112221174300_bib3","doi-asserted-by":"publisher","first-page":"R79","DOI":"10.1152\/ajpregu.00351.2014","article-title":"Role of renal sensory nerves in physiological and pathophysiological conditions","volume":"308","author":"Kopp","year":"2015","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"2025080112221174300_bib4","doi-asserted-by":"publisher","first-page":"2194","DOI":"10.1681\/ASN.2021111518","article-title":"Anatomical evidence for parasympathetic innervation of the renal vasculature and pelvis","volume":"33","author":"Cheng","year":"2022","journal-title":"J Am Soc Nephrol"},{"key":"2025080112221174300_bib5","doi-asserted-by":"publisher","first-page":"1728","DOI":"10.1172\/JCI114628","article-title":"A regulatory role for large vessels in organ circulation. 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