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Amiloride in Bartter's syndrome

G T Griffing, P Komanicky, S A Aurecchia

    Clinical Pharmacology and Therapeutics
    |June 1, 1982
    PubMed
    Summary
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    Amiloride effectively treats hypokalemia (low potassium) in Bartter syndrome, a kidney disorder. This potassium-sparing diuretic offers a safe and useful option when other treatments fail.

    Area of Science:

    • Nephrology
    • Pharmacology

    Background:

    • Bartter syndrome (BS) frequently presents with severe hypokalemia, proving resistant to conventional therapies.
    • Standard treatments include prostaglandin synthetase inhibitors, potassium supplements, and other potassium-sparing diuretics.

    Observation:

    • Four patients with Bartter syndrome were evaluated in an outpatient setting.
    • Amiloride, a novel sodium channel blocker, was administered at doses ranging from 10 to 40 mg/day.
    • Prior treatments were discontinued, and patients were observed before and during amiloride therapy.

    Findings:

    • Amiloride therapy led to a statistically significant increase in mean plasma potassium levels (0.5 mEq/l; P < 0.05).
    • Three out of four patients experienced elevated potassium levels, with one achieving normokalemia.

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  • Adverse reactions were minimal and not definitively linked to amiloride.

    • Implications:

    • Amiloride demonstrates potential as a safe and effective therapeutic agent for managing hypokalemia in Bartter syndrome.
    • This finding suggests a valuable alternative for patients with refractory hypokalemia due to BS.
    • Further research may confirm amiloride's role in BS management.