A woman aged 45 years was presented with hypokalemic metabolic alkalosis and hypomagnesemia associated with renal potassium and magnesium wasting. Her 24-hour urinary calcium excretion was strikingly low despite normocalcemia and normal creatinine clearance, which is one of characteristic findings of Gitelman's syndrome (GS). She was evaluated for the responses following Mg supplementation for 10 days, which showed marked increments in serum potassium and magnesium as well as improvements of the degree of renal potassium wasting and hypocalciuria. This amelioration of abnormal biochemical pictures in this patient after Mg supplementation proposes that the hypokalemia with renal potassium wasting and hypocalciuria may be caused by abnormal Mg metabolism.
Bartter's Disease/urine ; Bartter's Disease/therapy* ; Bartter's Disease/blood ; Calcium/urine* ; Case Report ; Female ; Food, Fortified ; Human ; Hypokalemia/therapy* ; Magnesium/blood* ; Middle Age ; Syndrome

Bartter's syndrome is a renal tubular disorder characterized by hypokalemia, metabolic alkalosis, increased urinary excretion of potassium and prostaglandins, a relative vascular resistance to the pressor effects of exogenous angiotensin II, and hyperplasia of the juxtaglomerular apparatus. In most patients, the glomerular filtration rate is normal and chronic renal failure does not develop. We report here on a case of living-related kidney transplantation in Bartter's syndrome, in which a non-steroidal anti-inflammatory drug is suspected to be the cause of the end-stage renal disease.
Adult ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects* ; Bartter's Disease/drug therapy* ; Case Report ; Human ; Indomethacin/adverse effects* ; Kidney Failure, Chronic/surgery* ; Kidney Failure, Chronic/chemically induced* ; Kidney Transplantation* ; Living Donors* ; Male