Recurrent Hypokalemia, Hypomagnesemia and Metabolic Alkalosis Following Preemptive Renal Transplantation: Bartter Syndrome

Native kidney function can still contribute to the total renal function after preemptive renal transplantation, and the primary problems of native kidneys such as tubular disorders may persist or reappear in the post-transplantation period. Bartter syndrome is a rare hereditary tubulopathy characterized by renal salt wasting, hypokalemia, metabolic alkalosis, and normotensive hyperreninemic hyperaldosteronism. In this case report, we described a patient who presented with episodes of recurrent hypokalemia, hypomagnesemia, and metabolic alkalosis in the post-transplantation period, probably due to the tubular disorder of the native kidneys. The primary kidney disease had not been adequately investigated in the pre-transplant period, and Bartter syndrome was the most likely diagnosis. Identifying primary kidney disease in the pre-transplantation period is important for patient follow-up.