In 90% of cases, neonatal Bartter syndrome is seen between 24
and 30 weeks of gestation with excess amniotic
fluid(polyhydamnios!" #fte bith, the infant is seen to uinate and
dink excessi$ely (polyuia, and polydipsia, especti$ely!"
%ife&theatening dehydation may esult if the infant does not
ecei$e ade'uate fluids" #bout ()% of infants dispose of excess
amounts of calcium in the uine (hypecalciuia! and kidneys
(nephocalcinosis!, which may lead to kidney stones" In ae
occasions, the infant may pogess to enal failue"*atients with
classic Bartter syndrome may ha$e symptoms in the fist two yeas of
life, but they ae usually diagnosed at school age o late" %ike
infants with the neonatal subtype, patients with classic +atte
syndome also ha$e polyuia, polydipsia, and a tendency to
dehydation, but nomal o ,ust slightly inceased uinay calcium
excetion without the tendency to de$elop kidney stones" -hese
patients also ha$e $omiting and gowth etadation" .idney function is
also nomal if the disease is teated,/20 but occasionally patients
poceed to end&stage enal failue" +atte1s syndome consists of
hypokalaemia, alkalosis, nomal to low blood pessues, and ele$ated
plasma enin and aldosteone" 2umeous causes of this syndome pobably
exist" 3iagnostic pointes include high uinay potassium and chloide
despite low seum $alues, inceased plasma enin, hypeplasia of the
,uxtaglomeula appaatus on enal biopsy, and caeful exclusion of
diuetic abuse" 4xcess poduction of enal postaglandins is often
found" 5agnesium wasting may also occu"
