成人Bartter综合征合并慢性肾功能不全急性加重1例

doi:10.3969/j.issn.1004-583X.2023.11.011

摘要/Abstract

摘要：

目的通过分析1例成人Bartter综合征合并慢性肾功能不全急性加重病例,探究Bartter综合征的发病、治疗及预后。方法选取甘肃省人民医院肾内科住院患者1例,回顾性分析其临床资料、治疗与转归,并进行讨论。结果本例患者表现为低钾血症、代谢性碱中毒、高肾素血症、高醛固酮血症,合并慢性肾功能不全急性加重,除外其他继发性醛固酮增多症的病因后,完善肾穿刺活检及基因检测,证实了Bartter综合征Ⅲ型的诊断。明确诊断后给予血液透析,螺内酯,补钾治疗后血钾恢复正常,肾功能明显好转。结论 Bartter综合征起病隐匿,长期的低钾血症以及高肾素血症等因素可能会引起肾小管间质性肾炎及肾小球病变,确诊后需及时进行补钾、保钾等一系列治疗。

关键词: Bartter综合征, 低钾血症, 慢性肾功能不全急性加重

Abstract:

Objective To explore the pathogenesis, treatment, and prognosis of Bartter syndrome by analyzing a case of acute exacerbation of chronic renal insufficiency in an adult with Bartter syndrome. Methods Clinical data, treatment and outcomes of a hospitalized patient from the Department of Nephrology at Gansu Provincial Hospital were retrospectively analyzed and discussed. Results The patient presented with hypokalemia, metabolic alkalosis, hyperreninemia, and hyperaldosteronism, accompanied by acute exacerbation of chronic renal insufficiency. After excluding other causes of secondary aldosteronism, and renal biopsy and genetic testing were performed to confirm the diagnosis of Bartter syndrome type Ⅲ. After a clear diagnosis, the patient was managed by blood dialysis, spironolactone, and potassium supplementation, and the blood potassium returned to normal and renal function improved significantly. Conclusion The onset of Bartter syndrome is insidious, and long-term hypokalemia and hyperreninemia may cause tubulointerstitial nephritis and glomerular lesions. After diagnosis, a series of treatments like potassium supplementation and potassium preservation should be timely carried out.

Key words: bartter syndrome, hypokalemia, acute exacerbation of chronic renal insufficiency

中图分类号:

R692.6

董慧, 黄文辉, 赵慧, 钱睿. 成人Bartter综合征合并慢性肾功能不全急性加重1例[J]. 临床荟萃, 2023, 38(11): 1022-1026.

Dong Hui, Huang Wenhui, Zhao Hui, Qian Rui. Adult Bartter syndrome complicated with acute exacerbation of chronic renal insufficiency: A case report[J]. Clinical Focus, 2023, 38(11): 1022-1026.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2023.11.011

https://huicui.hebmu.edu.cn/CN/Y2023/V38/I11/1022

图/表 1

参考文献 14

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