Zusammenfassung
Neben den allgemein bekannten Störungen des Säure-Basen-Haushalts durch renale Erkrankungen gibt es auch extrarenale Krankheitsbilder, die mit typischen metabolischen Störungen einhergehen. Unter diesen sind die Essstörungen Anorexia nervosa (AN) und Bulimia nervosa (BN), das Kurzdarmsyndrom sowie das Vorhandensein einer alternativen Harnableitung nach Zystektomie hervorzuheben. Diese drei Erkrankungen zeichnen sich zudem durch das erhöhte Risiko einer Nierenfunktionseinschränkung und Nephrolithiasis aus. Die metabolische Alkalose ist kennzeichnend für die AN und BN, dagegen wird bei Kurzdarmsyndrom und nach alternativer Harnableitung überwiegend eine metabolische Azidose beobachtet. Regelmäßige Kontrollen der Elektrolyte, des Säure-Basen-Status sowie der Nierenfunktion sind im Kurz- und Langzeitverlauf erforderlich.
Abstract
Besides the commonly known disturbances of the acid-base balance caused by renal diseases, there also exist extrarenal disease symptoms that are associated with typical metabolic disturbances. These include the eating disorders anorexia nervosa (AN) and bulimia nervosa (BN), the short-bowel syndrome and the presence of an alternative urinary diversion after cystectomy. These three diseases are also characterized by an increased risk of renal functional impairment and nephrolithiasis. Metabolic alkalosis is distinctive for AN (purging type) and BN; however, metabolic acidosis is predominantly observed in short bowel syndrome and after urinary diversion. Regular controls of electrolytes, acid-base status and renal function are required in the short and long term.
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U. Heemann, München
R.P. Wüthrich, Zürich
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Huber, M. Anorexia nervosa und Bulimia nervosa. Nephrologe 13, 12–18 (2018). https://doi.org/10.1007/s11560-017-0205-3
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DOI: https://doi.org/10.1007/s11560-017-0205-3