In order to clarify endocrinological changes before and after living-related
renal transplantation in a patient of
Bartter's syndrome involving
chronic renal failure, serial quantitative determinations of the renin-angiotensin-aldosterone system and 24-hour urinary excretion of 6-keto-prostaglandin F1 alpha and
kallikrein were performed. A male patient was admitted to hospital because of a pale face and short stature at the age of 13 years. He was 126 cm in height (M-3.8SD). Blood pressure was 110/60 mmHg and
edema was not observed. Laboratory findings showed that his hematocrit was 22.1%, serum
potassium 2.9 mEq/1,
creatinine clearance was 30.7 ml/min/1.73m2 and beta 2-microgobulin was elevated to 39.9 mg/1 in urinalysis. Plasma
renin activity and
aldosterone were remarkably elevated to 24.23 ng/ml/hr and 738 pg/ml, respectively. The kidney biopsy specimen showed diffuse glomerulosclerosis and hypertrophic change of the juxtaglomerular apparatus was also demonstrated. He was diagnosed as
Bartter's syndrome with short stature and
chronic renal failure. At the age of 18, he was introduced on
hemodialysis and the living-related
renal transplantation was performed the next year. Two weeks after the
transplantation, plasma
renin activity,
angiotensin, I,II and
aldosterone were markedly changed from 37.8 to 2.3 ng/ml/hr, 2400 to 220 pg/ml, 256 to 17 pg/ml and 3700 to 110 pg/ml, respectively. Urine
prostaglandin F 1 alpha was improved from 860 to 321 ng/day and
kallikrein was also changed from 400 to 25.2 micrograms/day. These results indicated that abnormalities of several
hormones in
Bartter's syndrome could be normalized by living-related
renal transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)