Bartter's Syndrome

In this condition there is an abnormality of the kidneys involving low Potassium levels in the blood due to wasting of Potassium by the kidneys, and metabolic alkalosis (i.e., blood pH is more basic than normal).  The blood pressure in the body is low or normal (compared to many kidney conditions, in which blood pressure is elevated).  The exact mechanism that causes the abnormalities present in Bartter's syndrome is still unknown, though over-production of prostaglandins (local hormones) has been implicated.  This disease is almost always diagnosed in childhood.

Weakness Muscle Cramps Frequent urination Frequent night urination

Genetic  Sometimes unknown

Chemistry panel reveals low Potassium and high bicarbonate levels.  Arterial blood gas shows alkalosis. Biopsy of the kidney shows hyperplasia of the juxtaglomerular complex and prominence of the medullary interstitial cells.  Interstitial fibrosis is also present in varying degrees.  (Note: a kidney biopsy is not always performed since the diagnosis can often be made without doing the biopsy). Urine should be screened for diuretics if there is no family history of this disorder Urine Electrolytes (sodium, Potassium, and Magnesium) are checked

Liberal intake of dietary sodium and Potassium Potassium supplements are often required to make up for the lost Potassium. Magnesium supplements for those who waste (lose) Magnesium. Spironolactone can reduce Potassium wasting (loss) by the kidneys. Prostaglandin synthetase inhibitors are helpful in some patients. Angiotensin-converting enzyme inhibitors (ACE inhibitors) are helpful for some individuals.

Diuretic ("water pill") abuse Magnesium deficiency Chronic vomiting from any cause

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