Abstract
The best described endocrinological form of hypokalemia in adults is Bartter's syndrome. Increased renal PG-synthesis secondary to decreased tubular reabsorption of chloride are thought to be involved in the pathogenesis of this syndrome. Systematic investigations of renal and systemic PG-production in chronic hypokalemia associated with various forms of renal tubular disorders in childhood are lacking. In 9 patients in the age of 3 m to 11 y (median:3 y) with these disorders urinary excretion (24h-urine) of PGE2 and PGF2α were determined as an index of renal PG-synthesis and of PGE-M and 6-k-PGF1α as an index of systemic PGE2 and PGI2 production. The normal range (10th-90th percentile) of PG-excretion rates in healthy infants (n=30) of the same age were as following (mass spectrometric(MS)-analysis): PGE2 2.7-13.0 (median: 7.2), PGF2α 11.6-47.3 (median:29.7), PGE-M 106-519 (median:269) and 6-k-PGF1α 3.9-24.7 (median:8.1) ng/h/1.73m2. In all 9 hypokalemic patients PGE2 excretion was elevated 3- to 19-fold when compared with the median of the control group; in 6 out of 8 patients PGE-M excretion was 3- to 18-fold elevated; no significant changes were observed in urinary PGF2α and 6-k-PGF1α levels. Considering that 8 out of the 9 patients depended on indomethacin treatment, it is proposed that MS determinations of PGE2 and PGE-M excretion provide a sensitive indicator for PG-mediated hypokalemia in childhood. - Supported by the DFG (Se 263-7)
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Seyberth, H., Kammer, J., Rascher, W. et al. Prostaglandin(PG)-mediated hypokalemic renal tubular disorders in childhood. Pediatr Res 18, 1221 (1984). https://doi.org/10.1203/00006450-198411000-00122
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DOI: https://doi.org/10.1203/00006450-198411000-00122