Gitelman's and Bartter's Syndromes: From Genetics to the Molecular Basis of Hypertension and More.

Verdiana Ravarotto, Giovanni Bertoldi, Lucia Federica Stefanelli, Federico Nalesso, Lorenzo A Calò

Journal: Kidney & blood pressure research 2022;47(9):556-564

PMID: 35858584

Abstract

BACKGROUND

Gitelman's and Bartter's syndromes (GS/BS) are rare genetic tubulopathies characterized by electrolyte imbalance and activation of the renin-angiotensin-aldosterone system (RAAS). These syndromes have intriguing biochemical and hormonal abnormalities that lead them to be protected from hypertension and cardiovascular and renal remodeling.

SUMMARY

In this review, we explore the biochemical/molecular mechanisms induced by the activation of the RAAS and its counterregulatory arm which is particularly activated in GS/BS patients, in the context of blood pressure regulation. In addition, we report our findings in the context of the COVID-19 pandemic where we observed GS/BS subjects being protected from infection.

KEY MESSAGES

The intracellular pathways induced by Ang II, starting from induction of oxidative stress and vasoconstriction, are crucial for the progression toward cardiovascular-renal remodeling and might be useful targets in order to reduce/halt the progression of Ang II/oxidative stress-induced cardiovascular-renal morbidity in several diseases.

© 2022 The Author(s). Published by S. Karger AG, Basel.

Address: Department of Medicine (DIMED) Nephrology, Dialysis and Transplantation Unit University of Padova, Padova, Italy.
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