Prostaglandins and aspirin therapy in Bartter's syndrome.

A young patient with Bartter's syndrome was treated for three months with 100 mg/kg/day of aspirin to inhibit prostaglandin synthesis. Clinical symptoms resolved and serum-potassium increased from 2-9 to 3-5 mmol/l. Urinary excretion and plasma concentration of prostaglandins E and F were significantly reduced during aspirin therapy. Plasma-renin activity declined from 85 to 20 ng/ml/h (normal 1-5-4 mg/ml/h) and hyperaldosteronism was corrected. These results suggest that overproduction of prostaglandins has a central role in the pathogenesis of Bartter's syndrome.