Pediatric Nephrology

, Volume 18, Issue 8, pp 729–730 | Cite as

Prevention of cardiac arrhythmias in pediatric patients with normotensive-hypokalemic tubulopathy

Current attitude among European pediatricians
  • Cinzia Cortesi
  • Pietro E. G. Foglia
  • Alberto Bettinelli
  • Mario G. Bianchetti
Editorial Commentary


Potassium deficiency predisposes to cardiac arrhythmias culminating in syncope or sudden death. Because of the uncertainty related to the possible occurrence of such cardiac arrhythmias in the context of normotensive-hypokalemic tubulopathies, 19 European pediatric nephrologists with a large experience of normotensive-hypokalemic tubulopathies were asked to answer a questionnaire. The responses suggest that inherited normotensive-hypokalemic tubulopathies per se do not strongly predispose to dangerous cardiac arrhythmias. However, cardiac arrhythmias may be acutely precipitated by drugs that prolong the QT interval, by diarrhea, or vomiting, and perhaps even by physical activity. Finally, the likelihood of dangerous arrhythmias in normotensive-hypokalemic tubulopathy is currently unknown.


Bartter disease Hypokalemia Hypomagnesemia Sudden cardiac death 



We acknowledge the support of the Associazione Bambino Nefropatico. The questionnaire was answered by the following: P. Bertolani (Modena, Italy), F. Cachat (Lausanne, Switzerland), D.A. Caringella (Bari, Italy), G. Colussi (Varese, Italy), G. Deschênes (Paris, France), F. Emma (Rome, Italy), M. Fischbach (Strasbourg, France), C. Holmberg (Helsinki, Finland), E. Levtchenko (Nijmegen, The Netherlands), C. Loirat (Paris, France), T.J. Neuhaus (Zürich, Switzerland), P. Niaudet (Paris, France), W. Proesmans (Leuven, Belgium), J. Rodríguez-Soriano (Bilbao, Spain), J. Strehlau (Hannover, Germany), B. Tönshoff (Heidelberg, Germany), and A.M. Wingen (Essen, Germany).


  1. 1.
    Bettinelli A, Vezzoli G, Colussi G, Bianchetti MG, Sereni F, Casari G (1998) Genotype-phenotype correlations in normotensive patients with primary renal tubular hypokalemic metabolic alkalosis. J Nephrol 11:61–69PubMedGoogle Scholar
  2. 2.
    Zelikovic I (2001) Molecular pathophysiology of tubular transport disorders. Pediatr Nephrol 16:919–935CrossRefPubMedGoogle Scholar
  3. 3.
    Fiset C, Kargacin ME, Kondo CS, Lester WM, Duff HJ (1996) Hypomagnesemia: characterization of a model of sudden cardiac death. J Am Coll Cardiol 27:1771–1776CrossRefPubMedGoogle Scholar
  4. 4.
    Materson BJ (1997) Diuretics, potassium, and ventricular ectopy. Am J Hypertens 10:68S–72SCrossRefPubMedGoogle Scholar
  5. 5.
    Weiner ID, Wingo CS (1997) Hypokalemia—consequences, causes, and correction. J Am Soc Nephrol 8:1179–1188PubMedGoogle Scholar
  6. 6.
    Vannacci A, Baronti R, Masini E, Ravaldi C, Ricca V (2002) Anorexia nervosa and the risk of sudden death. Am J Med 112:327–328CrossRefPubMedGoogle Scholar
  7. 7.
    Zanolari Calderari M, Vigier RO, Bettinelli A, Bianchetti MG (2002) Electrocardiographic QT prolongation and sudden death in renal hypokalemic alkalosis. Nephron 91:762–763CrossRefPubMedGoogle Scholar
  8. 8.
    Blomstrom-Lundqvist C, Caidahl K, Olsson SB, Rudin A (1989) Electrocardiographic findings and frequency of arrhythmias in Bartter's syndrome. Br Heart J 61:274–279PubMedGoogle Scholar
  9. 9.
    Bettinelli A, Tosetto C, Colussi G, Tommasini G, Edefonti A, Bianchetti MG (2002) Electrocardiogram with prolonged QT interval in Gitelman disease. Kidney Int 62:580–584CrossRefPubMedGoogle Scholar
  10. 10.
    Li H, Fuentes-Garcia J, Towbin JA (2000) Current concepts in long QT syndrome. Pediatr Cardiol 21:542–550CrossRefPubMedGoogle Scholar

Copyright information

© IPNA 2003

Authors and Affiliations

  • Cinzia Cortesi
    • 1
    • 2
  • Pietro E. G. Foglia
    • 1
    • 2
  • Alberto Bettinelli
    • 2
    • 3
  • Mario G. Bianchetti
    • 1
    • 2
    • 4
  1. 1.Division of NephrologyUniversity Children's HospitalBerneSwitzerland
  2. 2.Pediatric Renal UnitUniversity of Milan Medical SchoolMilanItaly
  3. 3.Division of PediatricsLeopoldo Mandic HospitalMerateItaly
  4. 4.Division of PediatricsSan Giovanni HospitalSwitzerland

Personalised recommendations