Simulacra of Bartter's Syndrome

Samuel Vaisrub, MD
JAMA. 1980;243(10):1075. doi:10.1001/jama.1980.03300360047028.
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A recent issue of Nephron (23:57-58, 1979) pays tribute to Dr Frederick Crosby Bartter on the occasion of his retirement, after 27 years of service as Chief of Endocrinology Section of the National Heart Institute, to become Chief of Staff for Research at the Veterans Administration Hospital in San Antonio, Tex. The issue features a symposium on hypertension and sodium and mineral metabolism—areas of research to which Bartter contributed generously over the years.

Although Bartter's contributions are spread widely over the vast field of hormonal-renal-body fluid interrelations, he is best known for the syndrome that bears his name. Characterized by hypokalemic alkalosis, severe hyperreninemia, secondary aldosteronism, normotension, unresponsiveness to angiotensin, and juxtaglomerular hyperplasia, the syndrome traces its proximal cause to defective chloride reabsorption in the ascending limb of Henle's loop (distal fractional chloride reabsorption of 0.4±0.08, as contrasted with the normal 0.92±0.04).

Despite the more than a quarter of a


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