Abstract
Gitelman’s (GS) and Bartter’s (BS) syndromes are rare, inherited autosomal recessive tubulopathies characterized by hypokalemia, metabolic alkalosis, renal sodium, chloride, and potassium and magnesium-wasting. While the treatment based on potassium, sodium, chloride, and magnesium supplementation in addition to other pharmacologic options are widely established, recommendations about the dietary approach to GS and BS still remain generic. In this review we focus on the dietary strategies to increase sodium, potassium, and magnesium intake in GS and BS patients. Potassium and magnesium-rich foods and supplements are considered together with those that may reduce through different mechanisms the potassium and magnesium plasma level. Magnesium supplementation is often poorly tolerated, causing abdominal pain and diarrhea in most patients. New formulations using liposome and, in particular, sucrosomial technology have been recently proposed for magnesium supplementation in order to increase magnesium supplement tolerability and intestinal absorption. The dietary approach to GS and BS may be very important in the therapeutic approach to these syndromes. Due to the relevance of the dietary approach to these syndromes, a nutritional counseling should always be recommended and the nutritionist should join nephrologists in the follow-up of GS and BS patient care.
Highlights
Gitelman’s syndrome (GS) [1] and Bartter’s syndrome (BS) [2] are two salt-losing tubulopathies characterized by hypokalemic metabolic alkalosis with high activation of the renin–angiotensin–aldosterone system, with high renin and aldosterone levels yet hypotension or normotension
The dietary approach to BS and GS can be done through sodium, potassium, and magnesium-rich foods and/or supplements containing these minerals
Some foods and beverages can contribute to reducing plasma potassium and magnesium levels and these patients or their parents, in the case of children with these syndromes, should know them and moderate the use of these beverages and foods
Summary
Gitelman’s syndrome (GS) [1] and Bartter’s syndrome (BS) [2] are two salt-losing tubulopathies characterized by hypokalemic metabolic alkalosis with high activation of the renin–angiotensin–aldosterone system, with high renin and aldosterone levels yet hypotension or normotension Both the diseases are recessively inherited, caused by inactivating mutations in genes’ encoding channels or cotransporters expressed in the thick ascending limb or in the distal convoluted tubule which engenders several subtypes of the diseases with different manifestations and severity. The presence of both hypocalciuria and hypomagnesemia, in addition to hypokalemia, are highly predictive for the clinical diagnosis of GS, whereas five different forms have been identified, characterized by hypokalemic and hypochloremic metabolic alkalosis, intravascular volume depletion because of renal salt wasting, hyperreninemia and hyperaldosteronism, and low to normal blood pressure depicting BS types 1–5 [3,4]. Henle’s loop and in the distal convoluted tubule depicting the Figure 1
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
