Alina T
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correct me if i'm wrong, but i know that Bartter's syn means hypokalemia, with metabolic alkalosis and normal or even low BP, even though there is a high renin / angiotensin level.
isn't it? :roll:
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| peekay
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I TOOK THOSE INFOS FROM UCV (BIOCHEM).
I READ IN MARK'S CLINICAL MED THAT THERE IS NL OR LOW B.P IN BARTTER'S SYND. I AM CONFUSED AS WELL . BUT IF YOU LOOK AT HIGN LEVEL OF RENIN IT EXPLAINS WHY PT WILL HAVE HIGH B.P AND ALSO HIGH PROSTAGLANDINS SYNTHESIS EXPLAINS IT AS WELL. IF ANY ONE FINDS MORE DETAIL PLEASE POST IN REPLY
THANKS EVERYONE FOR PARTICIPATION
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| Alina T
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hey peekay!! 
here's the explanation I've got on this case.
the main defect in this syndrome is impaired reabsorbtion of Na+ in the thick ascending loop of Henle --> Na wasted in urine along with its water (20 H2O for 1Na) --> volume depletion --> aldosterone release --> K+ wasted in urine --> hypokalemia.
hypoK is a stimulus for PG E2 synthesis (vasodilator) -->increased PG E2 stimulates further renin production.
Also: high aldosteron + high angiotensin II --> kalikrein --> bradikinin (vasodilator)
Thus, the normal BP is a consequence of the 2 actions:
VASODILATION - by bradikinin and PG E2
VASOCONSTRICTION - by angiotensin II
So even though u have high renin levels (coz of high PG E2), the vasoconstriction is counteracted by the vasodilation of BK and PG E2.
ISNT THAT INTERESTING?? 
By giving Indomethacin u block the release of PG and so inhibit the synthesis of renin. u also need K supplements and K-sparing diuretics to treat this syn.
i hope this is clear enough......I tryed...
and hey! guess what!!?? :shock:
my biochem UCV has a normal BP patient in this vignette :lol: :lol:
(3rd edition)
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There are 3 types of people: those who make things happen, those who watch things happen, and those who wonder what happened.
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| peekay
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Topics: 102
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THANKS ALINA . I AM USING 2ND EDITION UCV. SO I BELIEVE THERE IS A TYPO. I APPRECIATE YOUR EXPLANATION,THIS MAKES MORE SENSE NOW. THANKS
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| Alina T
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Topics: 17
Posts: 388
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:wink:
glad i could help
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