[Bartter syndrome].

The characteristic clinical features of Bartter syndrome consist of hypokalemia, hypochloremic metabolic alkalosis, and normal blood pressure despite hyperreninemia and hyperaldosteronism. Some are constantly present, such as juxtaglomelular hyperplasia, decrease of the pressor response for angiotensin II infusion, impairment of concentrating ability, and elevated prostaglandin E2 and I2, while others such as hypomagnesemia are observed in some cases. The primary cause remains unknown, but the most likely candidate is reduced sodium chloride reabsorption in the thick ascending limb of Henle's loop. Exclusion of pseudo-Bartter syndrome, mainly of surreptitious vomiting and diuretic abuse, is necessary to diagnose the syndrome. The current therapy focuses on multiple agents to reduce massive potassium loss and to inhibit the syntheses of prostaglandin.