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Journal für Endokrinologie, Diabetologie und Stoffwechsel

15.03.2024 | Originalien

Aldosteron und Niere – eine komplexe Interaktion

verfasst von: Dr. Christoph Schwarz, Prof. PD Dr. Gregor Lindner

Erschienen in: Journal für Endokrinologie, Diabetologie und Stoffwechsel

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Zusammenfassung

Aldosteron ist ein Hormon mit dualer Wirkung auf die Niere. Es ist einerseits Teil eines Regulationssystems zur Aufrechterhaltung des Natrium(= Volumen‑)Haushalts, andererseits ist es für die Stabilität des Kaliumhaushalts und des Säure-Basenhaushalts mitverantwortlich. Störungen des Aldosteronsystems kennzeichnen sich deshalb durch verminderten oder erhöhten S‑Kaliumspiegel bzw. Hypo- oder Hypertonie. Aldosteron wirkt am sogenannten Aldosteron-sensitiven Abschnitt des distalen Tubulus des Nephrons, wo es verschiedene Ionentransporter aktiviert, welche die Natriumresorption und die Kaliumsekretion fördern. Schwieriger zu verstehen ist, dass eine erhöhte Aldosteronaktivität nicht immer zu einer Hypokaliämie führt (Aldosteronparadoxon) und dass Störungen von (Aldosteron-abhängigen) Ionentransportern im distalen Tubulus der Niere zu scheinbar paradoxen Situationen führen, in denen das Ausmaß der Aldosteronsekretion in der Nebenniere nicht mit der zu erwartenden Aldosteronwirkung übereinstimmt (Pseudo-Hypo‑/Hyperaldosteronismus). Dahinter können sich seltene monogenetische Erkrankungen, aber auch erworbene Ursachen verbergen. Anhand von drei Fallbeispielen werden die wesentlichen Interaktionen zwischen Aldosteron und dem distalen Tubulusabschnitt der Niere erklärt.
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Metadaten
Titel
Aldosteron und Niere – eine komplexe Interaktion
verfasst von
Dr. Christoph Schwarz
Prof. PD Dr. Gregor Lindner
Publikationsdatum
15.03.2024
Verlag
Springer Vienna
Erschienen in
Journal für Endokrinologie, Diabetologie und Stoffwechsel
Print ISSN: 3004-8915
Elektronische ISSN: 3004-8923
DOI
https://doi.org/10.1007/s41969-024-00224-8