Clinical research

DOI: 10.4244/EIJ-D-23-00264

Histological examination of renal nerve distribution, density, and function in humans

Helge Struthoff1, MD; Lucas Lauder1; Mathias Hohl1, PhD; Alexander Hermens1, PhD; Abraham Rami Tzafriri2, PhD; Elazer R. Edelman3,4, MD, PhD; Michael Kunz1, MD; Michael Böhm1, MD; Thomas Tschernig5, MD; Felix Mahfoud1, MD, MA

Abstract

Background: Renal denervation is optimised when guided by knowledge of nerve distribution.

Aims: We aimed to assess sympathetic nerve distribution along the renal arteries, especially in post-bifurcation vessel segments.

Methods: Renal arteries and surrounding tissue from 10 body donors were collected and examined histologically. Immunohistochemical staining was used to analyse nerve distribution and to identify afferent and efferent sympathetic nerves.

Results: A total of 6,781 nerves surrounding 18 renal arteries were evaluated. The mean lumen-nerve distance of the left renal artery (2.32±1.95 mm) was slightly greater than the right (2.29±2.03 mm; p=0.161); this varied across the arteries’ courses: 3.7±2.3 mm in proximal segments, 2.5±2.0 mm in middle segments, 1.9±1.6 mm in distal prebifurcation segments and 1.3±1.0 mm in post-bifurcation segments (p<0.001). The number of nerves per quadrant was highest in the proximal segments (13.7±18.6), followed by the middle (9.7±7.9), distal prebifurcation (8.0±7.6), and distal post-bifurcation (4.3±4.0) segments (p<0.001). Circumferentially, the number of nerves was highest in the superior (7.8±9.4) and the ventral (7.6±13.1) quadrants (p=0.638). The mean tyrosine hydroxylase (TH) to calcitonin gene-related peptide (CGRP) ratio increased from proximal (37.5±33.5) to distal (72.0±7.2 in the post-bifurcation...

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Volume 19 Number 7
Sep 18, 2023
Volume 19 Number 7
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