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  1. Primary defect in NaCl absorption at ascending limb of the loop of Henle
  2. Volume depletion → aldosterone    - Kaliuresis
  3. More NaCl delivered to distal tubules - Hypokalemia

Hypokalemia further increase aldosterone production by stimulating release of prostaglandin E2 and 12 which promote secretion of Renin.


Clinical Feature:


Severe form of Barter syndrome [Hyper Prostaglandin E syndrome] may afflict new characterized by poly hydramnios, Prematurity, Dehydration and growth failure. Young children have growth failure, muscle weakness, constipation, polyuria.



  1. Oral potassium supplement
  2. K + sparing diuretics
  3. Indomethacin – inhibit PG synthesis
  4. B – blocker ↓  Renin level

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