We have followed four patients with Bartter syndrome for a mean of 25.4 years (range 21.5-28.8 years) after diagnosis. All patients received non-steroidal anti-inflammatory drugs (NSAID). In all patients, various degrees of renal dysfunction were noted to be temporally associated with NSAID therapy. In two patients, renal dysfunction resolved after discontinuing NSAID therapy, while maintaining other chronic medications such as potassium-sparing diuretics. Renal dysfunction persisted after NSAID withdrawal in two patients. We report these cases as a warning that NSAID should be considered an important cause of either reversible or irreversible renal dysfunction in Bartter syndrome.
Pediatr Nephrol 1998 Nov;12(9):775-7, Schachter AD, Arbus GS, Alexander RJ, Balfe JW
Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Ontario, Canada.
PMID: 9874326, UI: 99089722
To describe prenatal genetic diagnosis in hyperprostaglandin E syndrome (HPS) and the effect of indomethacin therapy on the course of the disease before birth and in the neonatal period.
Neonatal Bartter syndrome differs from the classical Bartter syndrome in the occurrence of antenatal presentation with polyhydramnios. Nephrocalcinosis and severe growth retardation are common sequelae. Indomethacin has been reported to improve linear growth, but its use in the early newborn period has been infrequently described.
Amiloride works by inhibiting sodium reabsorption in the distal convoluted tubules and collecting ducts in the kidneys. This promotes the loss of sodium and water from the body, but without depleting potassium. The drug is often used in conjunction with thiazide or loop diuretics. Patients with Bartter or Gitelman Syndromes benefit from this by keeping their potassium levels up.
Potassium-sparing diuretics are commonly used to help reduce the amount of water in the body. Unlike some other diuretics, these medicines do not cause your body to lose potassium.
Medications and Supplements
The goal in treating Bartter and Gitelman patients is to correct the underlying electrolyte abnormalities and to prevent further wasting of these electrolytes. Below is a list of the most commonly used medications.
Table of Contents
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Why is this medication prescribed?
Lisinopril is used alone or in combination with other medications to treat high blood pressure. It is used in combination with other medications to treat heart failure. Lisinopril is also used to improve survival after a heart attack. Lisinopril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently. Bartter or Gitelman patients may be prescribed this drug because it selectively suppresses renin-angiotensin-aldosterone system; inhibits ACE, preventing conversion of angiotensin I to angiotensin II
Amiloride is one of the prescription medications your Dr. might prescribe to help you keep your potassium level up. Despite the long list of possible adverse reactions below, most people who take Amiloride experience no side effects at all.
Short stature and growth failure are common in Bartter’s Syndrome. In subjects with growth hormone deficiency, giving exogenous growth hormone increases the rate of growth and helps subjects attain normal height.
Indomethacin- A nonsteroidal anti-inflammatory drug (NSAID) used in Bartter’s syndrome to help improve growth in children and decrease urinary potassium excretion.