Option of pre-emptive nephrectomy and renal transplantation for Bartter's syndrome.
Bartter's syndrome (BS) is an incurable genetic disease, with variable response to supportive therapy relating to fluid and electrolyte management. Poor control or therapy non-compliance may result in frequent life threatening episodes of dehydration, acidosis and hypokalemia, with resultant adverse effects on patient quality of life (QOL). We report, for the first time, pre-emptive bilateral native nephrectomies and successful renal transplantation, prior to the onset of ESRD, for severe, clinically brittle, neonatal BS, resulting in correction of metabolic abnormalities and excellent graft function. We propose that fragile BS should be considered as a possible indication for early native nephrectomies and pre-emptive renal transplantation, procedures that results in a 'cure' for the underlying disease and significant improvements in patient QOL.
Department of Pediatrics and Surgery, Stanford University, CA, USA.
Abanti
A
Chaudhuri
Oscar
O
Salvatierra
Steven R
SR
Alexander
Minnie M
MM
Sarwal
D001477:Bartter Syndrome / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D001827:Body Height; D001835:Body Weight; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D009392:Nephrectomy; D010530:Peritoneal Dialysis; D011788:Quality of Life