The clinical findings characteristic of Bartter syndrome are hypokalemia, metabolic alkalosis, and normal to low blood pressure. These findings may also be caused by other conditions, which may cause confusion. When diagnosing a Bartter's syndrome, the following conditions must be ruled out as possible causes of the symptomatology: Chronic vomiting: These patients will have low urine chloride levels; they have relatively higher urine chloride levels. Abuse of diuretic medications (water pills): The physician must screen urine for multiple diuretics before  diagnosis is made. Magnesium deficiency and calcium deficiency: These patients will also have low serum and urine magnesium and calcium. Treatment Medically supervised sodium, chloride and potassium supplementation is necessary, and spironolactone can be also used to reduce potassium loss. Free and unqualified access to water is necessary to prevent dehydration, as patients maintain an appropriate thirst response.In severe cases where supplementation alone cannot maintain biochemical homeostasis, nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to reduce glomerular filtration , and can be very useful, although may cause gastric irritation and should be administered alongside stomach acid suppression therapies. Angiotensin-converting enzyme (ACE) inhibitors can also be used to reduce glomerular filtration rate. In young babies and children, a low threshold to check serum electrolytes during periods of illness compromising fluid intake in necessary.
The clinical findings characteristic of Bartter syndrome is hypokalemia, metabolic alkalosis, and normal to low blood pressure. These findings may also be caused by other conditions, which may cause confusion. When diagnosing a Bartter's syndrome, the following conditions must be ruled out as possible causes of the symptomatology: Chronic vomiting: These patients will have low urine chloride levels; they have relatively higher urine chloride levels. Abuse of diuretic medications (water pills): The physician must screen urine for multiple diuretics before a diagnosis is made. Magnesium deficiency and calcium deficiency: These patients will also have low serum and urine magnesium and calcium. Treatment Medically supervised sodium, chloride and potassium supplementation is necessary, and spironolactone can be also used to reduce potassium loss. Free and unqualified access to water is necessary to prevent dehydration, as patients maintain an appropriate thirst response.In severe cases where supplementation alone cannot maintain biochemical homeostasis, nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to reduce glomerular filtration and can be very useful, although may cause gastric irritation and should be administered alongside stomach acid suppression therapies. Angiotensin-converting enzyme (ACE) inhibitors can also be used to reduce glomerular filtration rate. In young babies and children, a low threshold to check serum electrolytes during periods of illness compromising fluid intake is necessary.
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