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