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Role of the kidney in hormone metabolism and its implications in clinical medicine

Rolle der Niere im Hormonstoffwechsel und ihre Bedeutung für die klinische Medizin

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Zusammenfassung

Die Urämie wird von verschiedenen metabolischen und endokrinen Störungen begleitet, die einerseits die Degradation hormonal aktiver Peptide in der erkrankten Niere behindern, andererseits durch direkte Auswirkungen des urämischen Milieus auf die extrarenale Degradation verschiedener Hormone, ihre Synthese oder Sekretion hervorgerufen sind. Es gelingt nicht immer, eine direkte Ursachen-Wirkung-Beziehung zwischen Änderungen des immunreaktiven Hormonspiegels und endokriner Funktionsstörung herzustellen, da in der Uramie die zirkulierende hormonale Immunreaktivität häufig kreuzreagierende Komponenten ohne biologische Aktivität einschließt und zusätzlich die Wirkung verschiedener Hormone auf ihre Zielorgane verändert ist. Abweichungen im Stoffwechsel der pankreatischen α- und β-Zellhormone und von Prolactin bei chronischem Nierenversagen sowie ihr Effekt auf den Stoffwechsel von Lipiden und Kohlenhydraten und auf die reproduktive Funktion werden in diesem Zusammenhang diskutiert.

Summary

Uremia is accompanied by a variety of metabolic and endocrine disorders, due in part to impaired degradation of hormonally active peptides by the diseased kidney, and in part to the fact that the uremic environment interferes with the extrarenal degradation of certain hormones, or with their synthesis or secretion. It is not always possible to establish a direct cause and effect relationship between alterations in immunoassayable hormone levels and endocrine abnormalities because in uremia the circulating hormonal immunoreactivity frequently includes crossreacting components without biological activity and, in addition, hormonal effects on target organs are often altered. Alterations in the metabolism of pancreatic alpha and beta cell hormones and of prolactin in chronic renal failure and their effect on the metabolism of lipids and carbohydrates and on reproductive function in this condition are discussed.

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Authors and Affiliations

  1. Departments of Medicine and Obstetrics and Gynecology, Division of Biological Sciences, The University of Chicago, Pritzker School of Medicine, 60637, Chicago, IL, USA

    D. S. Emmanouel MD, M. D. Lindheimer & A. I. Katz

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  1. D. S. Emmanouel MD
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  2. M. D. Lindheimer
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  3. A. I. Katz
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Supported in part by grants AM-13601, AM-19250 and HD-5572 5572 from the NIH and by the Chicago Heart Association

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Emmanouel, D.S., Lindheimer, M.D. & Katz, A.I. Role of the kidney in hormone metabolism and its implications in clinical medicine. Klin Wochenschr 58, 1005–1012 (1980). https://doi.org/10.1007/BF01476870

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  • DOI: https://doi.org/10.1007/BF01476870

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