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Bartter Syndrome Treatment — ESENeph MCQ

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ModerateTubular DisordersBartter Syndrome TreatmentESENeph

A 45-year-old man with Bartter syndrome (confirmed genetically, ROMK mutation) has hypokalaemia, metabolic alkalosis, and normal blood pressure despite elevated renin and aldosterone. Which medication class will NOT help correct his electrolyte abnormalities?

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Correct answer: E — Thiazide diuretic

Bartter syndrome mimics the effect of a loop diuretic (defective sodium reabsorption in the thick ascending limb). Treatment includes potassium supplementation, potassium-sparing diuretics (Amiloride, Spironolactone), NSAIDs (Indometacin – reduces prostaglandin-mediated renal potassium wasting), and sometimes ACEi/ARBs to reduce aldosterone. Thiazide diuretics would worsen potassium wasting by blocking distal sodium reabsorption and are contraindicated.

Reference: Kleta and Bockenhauer 2006 – Bartter and Gitelman Syndromes