Bartter syndrome and focal segmental glomerulosclerosis: a possible link between two diseases

We describe a patient with signs and symptoms of classic Bartter syndrome. The patient tested negative for all known genetic abnormalities associated with this tubular disorder. Proteinuria was found within 1 year after the d iagnosis of Bartter syndrome. A renal biopsy performed 6 months later, when her kidney function was normal, revealed focal segmental glomerulosclerosi s (FSGS). We propose a link between stimulation of the renin-angiotensin sy stem and sclerotic changes in the glomerulus. This lesion may explain previ ous reports of kidney failure in patients with Bartter syndrome.