A REAPPRAISAL OF ALDOSTERONE EFFECTS ON THE KIDNEY - NEW INSIGHTS PROVIDED BY EPITHELIAL SODIUM-CHANNEL CLONING

Sodium homeostasis is crucial for the control of extracellular volume and blood pressure. Regulation of sodium reabsorption is mainly achiev ed in the distal nephron by the mineralocorticoid aldosterone, but the molecular pathway of aldosterone action has largely remained unclear, Molecular genetic analysis of inherited diseases disturbing sodium ho meostasis has now demonstrated that the amiloride-sensitive epithelial sodium channel is a major effector of aldosterone action, Mechanisms by which aldosterone regulates the epithelial sodium channel activity are beginning to emerge and will be of great importance for a better u nderstanding of salt-sensitive hypertension.