+1 Recommend
1 collections
      Call for Papers in Kidney and Blood Pressure ResearchKidney Function and Omics Science

      Submission Deadline: December 20, 2023

      Submit now

      • Record: found
      • Abstract: found
      • Article: found

      Discrepancy between Lithium and Free Water Clearance in Patients with Bartter’s Syndrome


      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.


          Lithium and free water clearance (C<sub>Li </sub>and C<sub>H2O</sub>) were measured simultaneously in 5 patients with Bartter’s syndrome (BS), and the results were compared with values obtained in a large group of healthy control subjects. In line with the literature, fractional diluting segment reabsorption estimated from C<sub>H2O</sub> appeared to be subnormal in BS (82.4 ± 4.7 versus 89.4 ± 4.4% in controls, p < 0.01). Fractional delivery to this segment, expressed as the maximum urine flow during water diuresis (V<sub>max</sub>/glomerular filtration rate, GFR), also appeared to be reduced (11.3 ± 1.6 versus 13.8 + 2.5%, p < 0.05), suggesting compensatory increased proximal reabsorption. In disagreement with the latter, C<sub>Li</sub>/GFR, alleged to be a measure of fractional sodium and water output from the proximal tubules, was increased (36.2 ± 1.8 versus 30.7 ± 5.1% in controls, p < 0.01), suggesting that suppressed proximal reabsorption could be the primary reabsorption defect in BS. During chronic converting enzyme inhibition with enalapril, given to treat hypokalemia (3 patients), the concordance between the two methods was restored because C<sub>Li</sub>/GFR fell by approximately 50%, whereas V<sub>Max</sub>/GFR did not change; the alleged diluting segment rabsorption defect remained present. These contradictory results lead to the conclusion that one of the two methods reflected the pattern of tubular sodium handling in BS incorrectly. However, the present study does not unequivocally indicate which method yielded erroneous results in this condition.

          Related collections

          Author and article information

          S. Karger AG
          17 December 2008
          : 67
          : 1
          : 82-87
          Department of Nephrology and Hypertension, University Hospital, Utrecht, The Netherlands
          187892 Nephron 1994;67:82–87
          © 1994 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          : 24 June 1993
          Page count
          Pages: 6
          Original Paper

          Cardiovascular Medicine,Nephrology
          Proximal tubule,Converting enzyme inhibition,Diluting segment,Hypokalemia


          Comment on this article