Landau D
Department of Pediatrics A, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva 84101, Israel.
Cell Mol Life Sci. 2006 Sep;63(17):1962-8. doi: 10.1007/s00018-006-6011-0.
Hyper- and hypokalemia may carry severe clinical consequences. Different regulatory mechanisms, including the kidney, exert a tight regulation of plasma potassium levels. The renal pathway of potassium handling begins in the proximal tubule followed by the fine-tuning of its secretion or absorption at the distal tubule, including the thick ascending limb of Henle's loop, the distal convoluted tubule and the cortical collecting duct. Genetic studies in recent years have clarified the role of specific tubular channels and transporters in the pathogenesis of unique hyper- and hypokalemic tubulopathies, some of them non-hypertensive (pseudohypoaldosteronism, Bartter and Gitelman syndromes) and others hypertensive by definition (including Liddle and Gordon syndromes). This article reviews the genetic and clinical spectrum of hypokalemic and hyperkalemic tubulopathies.
高钾血症和低钾血症可能会带来严重的临床后果。包括肾脏在内的不同调节机制对血浆钾水平进行严格调控。肾脏处理钾的途径始于近端小管,随后在远端小管(包括髓袢升支粗段、远曲小管和皮质集合管)对其分泌或重吸收进行微调。近年来的遗传学研究阐明了特定肾小管通道和转运体在独特的低钾血症和高钾血症肾小管病发病机制中的作用,其中一些为非高血压性(假性醛固酮增多症、巴特综合征和吉特曼综合征),而另一些根据定义为高血压性(包括利德尔综合征和戈登综合征)。本文综述了低钾血症和高钾血症肾小管病的遗传学和临床谱。