Bartter's Syndrome: Urinary Prostaglandin E-like Material and Kallikrein; Indomethacin Effects

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Abstract
The urinary excretions of prostaglandin E-like material (iPGE) and kallikrein were measured in 2 children with Bartter''s syndrome. Urinary iPGE excretion was 3 and 10 times greater than normal, and urinary kallikrein was 5 and 10 times greater than normal in the 2 subjects. Excretions of iPGE and kallikrein were highly correlated (P < 0.005) with each other before and during treatment with indomethacin, a prostaglandin synthetase inhibitor. Indomethacin significantly (P < 0.001) reduced urinary iPGE, urinary kallikrein and plasma renin activity while increasing sensitivity to i.v. angiotensin II and serum K to normal. Renal PG may be involved in pathogenesis of Bartter''s syndrome, that renal PG and the kallikrein-kinin system may be linked.

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