Article: article from journal or magazin.
Use of calcium excretion values to distinguish two forms of primary renal tubular hypokalemic alkalosis: Bartter and Gitelman syndromes
Journal of Pediatrics
Journal Article --- Old month value: Jan
Clinical or biochemical findings were reevaluated in 34 pediatric patients with primary renal tubular hypokalemic metabolic alkalosis. The patients were subdivided into two groups. Bartter syndrome (primary renal tubular hypokalemic metabolic alkalosis with normocalciuria or hypercalciuria) was diagnosed in 18 patients with molar urinary calcium/creatinine ratios greater than 0.20, and Gitelman syndrome (primary renal tubular hypokalemic metabolic alkalosis with magnesium deficiency and hypocalciuria) was diagnosed in 16 patients with molar urinary calcium/creatinine ratios less than or equal to 0.20 and plasma magnesium levels less than 0.75 mmol/L. Some clinically important differences between the groups were observed. Patients with Bartter syndrome were often born after pregnancies complicated by polyhydramnios (8/18) or premature delivery (7/18) and had short stature (11/18) or polyuria, polydipsia, and a tendency to dehydration (16/18) during infancy (12/18) or before school age (18/18). Patients with Gitelman syndrome had tetanic episodes (12/16) or short stature (3/16) at school age (14/16). We conclude that the Bartter and Gitelman syndromes represent two distinct variants of primary renal tubular hypokalemic metabolic alkalosis and are easily distinguished on the basis of urinary calcium levels.
Alkalosis/blood/*diagnosis/genetics/urine Bartter Syndrome/*diagnosis/genetics Bicarbonates/blood Calcium/blood/*urine Child Child, Preschool Chlorides/blood/urine Creatinine/urine Diagnosis, Differential Female Humans Hypokalemia/blood/*diagnosis/genetics/urine Infant Infant, Newborn Juxtaglomerular Apparatus/pathology Kidney Tubules/pathology Magnesium/urine Magnesium Deficiency/blood/*diagnosis/genetics/urine Male Osmolar Concentration Phosphates/blood Potassium/urine Renin/blood Seizures/physiopathology Sodium/blood/urine Syndrome Tetany/physiopathology
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