Chronic renal failure, end-stage renal disease, and peritoneal dialysis inGitelman's syndrome

The chronic state of hypovolemia, hypotension, and hypokalemia found In Bar tter's syndrome has been shown to lead to a chronic nephropathy, which then can progress toward end-stage renal disease end dialysis, This progression , however, has never been reported for Gitelman's syndrome, a variant of Ba rtter's syndrome that shows a milder clinical picture. This report is the f irst to document this progression tie, the development of end-stage renal d isease in Gitelman's syndrome) as well as the first report of the use of pe ritoneal dialysis in either Bartter's syndrome or Gitelman's syndrome. The clinical course highlights the importance of and the need for careful contr ol of hemodynamic status in these patients to slow the progression of renal injury. The hemodynamic alterations that characterize Bartter's syndrome a nd Gitelman's syndrome patients suggest that for patients requiring renal r eplacement therapy, peritoneal dialysis is a more appropriate treatment bec ause of its less severe impact on these parameters. (C) 2001 by the Nationa l Kidney Foundation, Inc.