Bartter-, Gitelman-, and Related Syndromes

The focus of this chapter are different disorders of primary renal salt-wasting caused by inherited dysfunction of ion-transporting proteins expressed along the thick ascending limb (TAL) of Henle’s loop and along the early distal convoluted tubule (DCT). The clinical presentation, the underlying pathophysiology resulting from the different gene defects and the therapeutic approaches for the Bartter-like syndromes, Gitelman syndrome and EAST syndrome will be discussed in detail. Renal salt-wasting due to impaired sodium reabsorption along the aldosterone-sensitive distal nephron (ASDN) composed of the late DCT, the connecting tubule (CNT), and the collecting duct (CD) is accompanied by hyperkalemia and is discussed elsewhere.