Reversal of altered vascular responsiveness in Bartter's syndrome by indomethacin treatment.

The effects of indomethacin treatment on the vascular response to 5-valine-angiotensin II amide, [sarcosine, isoleucine] angiotensin II, and D-3-mercapto-2-methylpropanoyl-L-proline were examined in a patient with Bartter's syndrome. Indomethacin (150 mg/day) was administered for 5 days. PRA decreased from 74.1 to 3.2 ng/ml.h during this period. With this treatment, the normal pressor response to the synthetic angiotensin II was restored, and the hypotensive response to the angiotensin II antagonist and the converting enzyme inhibitor was markedly diminished. These results suggest that altered vascular responsiveness in Bartter's syndrome would be secondary to hormonal derangements.