[Bartter's syndrome: the long term effects of indomethacin on growth (author's transl)]

Area of Science:

• Pediatric Endocrinology
• Nephrology
• Genetic Disorders

Background:

• Bartter's syndrome is a rare genetic kidney disorder characterized by salt wasting, leading to electrolyte imbalances and impaired growth in children.
• Understanding the impact of therapeutic interventions on growth and development in pediatric Bartter's syndrome is crucial for clinical management.

Observation:

• Six children diagnosed with Bartter's syndrome, ranging in age from 6 years 4 months to 13 years 11 months, were administered indomethacin.
• Treatment duration varied between 7 and 27 months, with dosages ranging from 1.7 to 4.3 mg/kg/day.

Findings:

• Indomethacin administration resulted in an initial period of catch-up growth and weight gain in the pediatric patients.
• Following the catch-up phase, the children's growth curves became parallel to normal growth trajectories.
• Osseous maturation, or bone age advancement, was observed to be faster, indicating accelerated skeletal development, even with only partial correction of serum potassium and plasma renin activity.

Implications:

• Indomethacin therapy can effectively improve growth parameters in children suffering from Bartter's syndrome.
• The findings suggest that indomethacin may play a significant role in managing the growth-defying aspects of Bartter's syndrome.
• Further research could explore optimal dosing and long-term effects of indomethacin on skeletal and overall development in this patient population.