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Abdominelle Koarktation und Nierenarterienstenose im Kindesalter

  • Andreas Heusch
  • A. Voiculescu
Chapter

Zusammenfassung

Eine arterielle Hypertonie im Kindesalter hat in etwa 1/3 der Fälle eine renovaskuläre Ursache [36]. Differenzialdiagnostisch müssen eine Nierenarterienstenose und eine Bauchaortenstenose unterschieden werden. Die Synonyme abdominelle Koarktation (CoA abd.), Bauchaortenstenose und Mid-Aortic-Syndrom (MAS) definieren eine Einengung der Aorta und ihrer äste unterhalb des Zwerchfells. Diese führt, ähnlich wie die Aortenisthmusstenose oder die thorakale Aortenstenose, zu einer Erhöhung des Blutdrucks in der oberen Körperhälfte und zu einer Minderperfusion distal der Stenose. In etwa 80–90% der Fälle sind auch die Nierenarterien betroffen [29]. Die Minderperfusion der Nieren führt zu einer Stimulation der Reninausschüttung, die die wesentliche Ursache für die Blutdruckerhöhung darstellt. In Abhängigkeit davon, ob eine oder beide Nieren von einer Perfusionsminderung betroffen sind, entstehen in Anlehnung an die Goldblatt- Modelle entweder eine renin- oder eine volumenabhängige Hypertonie [12, 23].

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Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • Andreas Heusch
    • 1
  • A. Voiculescu
  1. 1.Kinderkardiologie und -pulmologie Zentrum für Kinder- und JugendmedizinHelios Klinikum Wuppertal Standort BarmenWuppertal

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