... in ion transport by thick ascending limb cells.Dysfunction of these three proteins is predicted to impair transepithelial NaCl transport, leading to salt wasting and extracellular fluid volume contraction. The Bartter and Gitelman syndromes represent two distinct variants of primary renal tubular hypokalemic metabolic alkalosis and are easily distinguished on the basis of urinary calcium levels. Bartter's syndrome is a severe disorder characterised by normocalciuria or hypercalciuria, but the plasma magnesium concentration is not considered in establishing this diagnosis. Patients have a molar urinary calcium/creatinine ratio of>0.20. Gitelman's syndrome is a benign disorder characterised by magnesium deficiency and hypocalciuria. The molar urinary calcium/creatinine ratios are <0.20, and the plasma magnesium levels <0.75mmol/l. The mediators both of calcium transport into the urine and magnesium reabsorption in the DCT remain to be fully elucidated, and thus the basis for the hypocalciuria and hypomagnesemia are not explained as yet. As compared with Bartter's ...

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