Electrolyte and Water Metabolism

Another major function of the adrenal cortex is the regulation of water and electrolyte metabolism. The principal mineralocorticoid, aldosterone, can increase the rate of sodium reabsorption and potassium excretion sever-alfold. This will occur physiologically in response to sodium or volume depletion or both. The primary site of this effect is the distal tubule (see Chapter 21). The steroid-binding specificity of mineralocorticoid and glu-cocorticoid receptors overlaps in the distal cortical cells and collecting tubules, so that glucocorticoids may mediate mineralocorticoid-like effects. Glucocorticoids also decrease the intestinal transport of calcium by antagonizing the action of 1,25-dihydroxyvitamin D3 and promote calcium excretion by the kidney (see Chapter 66).

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