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Síndrome de Bartter

Definición

Se refiere a un grupo raro de enfermedades que afectan los riñones.

Causas

Se sabe que hay cinco defectos genéticos asociados con el síndrome de Bartter. La afección está presente al nacer (congénita).

La afección es causada por un defecto en la capacidad del riñón para reabsorber el potasio. Las personas afectadas por el síndrome de Bartter pierden demasiado sodio a través de la orina. Esto causa un aumento en el nivel de la hormona aldosterona y lleva a que los riñones eliminen demasiado potasio del cuerpo, lo cual se conoce como pérdida de potasio.

La afección también ocasiona un equilibrio ácido anormal en la sangre, llamado alcalosis hipocaliémica, que provoca demasiado calcio en la orina.

Síntomas

Esta enfermedad generalmente se presenta en la infancia. Los síntomas incluyen:

• Estreñimiento
• Menos aumento de peso que otros niños de edad y sexo similares (retraso del desarrollo)
• Micción frecuencia (frecuencia urinaria)
• Hipotensión arterial
• Cálculos renales
• Debilidad y calambres musculares

Pruebas y exámenes

Este síndrome generalmente se sospecha cuando un examen de sangre detecta un nivel bajo de potasio en la sangre. A diferencia de otras formas de enfermedad renal, esta afección no causa hipertensión arterial. Hay una tendencia hacia la hipotensión arterial. Los exámenes de laboratorio pueden mostrar:

• Niveles urinarios altos de potasio, calcio y cloruro 
• Niveles sanguíneos altos de las hormonas, renina y aldosterona
• Nivel bajo de cloruro en la sangre
• Alcalosis metabólica

Estos mismos signos y síntomas también se pueden presentar en las personas que toman demasiados diuréticos o laxantes. Se pueden hacer exámenes de orina para descartar otras causas.

Se puede hacer una ecografía de los riñones.

Tratamiento

El síndrome de Bartter se trata consumiendo alimentos ricos en potasio o tomando suplementos de este elemento.

Muchas personas también necesitan suplementos de sal y de magnesio. Se puede necesitar un medicamento que bloquee la capacidad del riñón para eliminar el potasio. De igual manera, se pueden usar dosis altas de antiinflamatorios no esteroides (AINE).

Expectativas (pronóstico)

Los bebés que presentan un retraso considerable del desarrollo pueden crecer normalmente con tratamiento. Con el tiempo, algunas personas con esta afección desarrollarán insuficiencia renal.

Cuándo contactar a un profesional médico

Consulte con el médico si su hijo:

• Está presentando calambres musculares
• No está creciendo bien
• Está orinando con frecuencia

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