Symptoms:

This disease usually occurs in childhood. Symptoms include:

• Constipation
• Growth failure
• Increased frequency of urination
• Low blood pressure
• Kidney stone
• Muscle cramping and weakness

Signs and tests:

The diagnosis of Bartter syndrome is usually suspected by finding low levels of potassium in the blood. The potassium level is usually less than 2.5 mEq/L. Unlike other forms of kidney disease, this condition does not cause high blood pressure and there is a tendency toward low blood pressure. Other signs of this syndrome include:

• High levels of potassium, calcium, and chloride in the urine
• High levels of the hormones renin and aldosterone in the blood
• Low blood chloride
• Metabolic alkalosis

These same signs and symptoms can also occur in people who have taken too many diuretics or laxatives. Urine tests can be done to rule out these causes.

In Bartter syndrome, a biopsy of the kidney typically shows too much growth of kidney cells called the juxtaglomerular apparatus. However, this is not found in all patients, especially in young children.