Gitelman and Bartter Syndrome in a Patient With Morbid Obesity: A Case Report and Literature Review

TL;DR

A morbidly obese man with suspected kidney disorder showed improved electrolyte levels after weight-loss surgery, suggesting a link between surgery and kidney function.

Contribution

This case highlights the potential impact of metabolic surgery on renal tubular function in patients with suspected Bartter–Gitelman syndrome.

Findings

The patient's electrolyte levels normalized after sleeve gastrectomy without medication.

The case suggests a possible relationship between metabolic surgery and improved renal tubular function.

Unexplained electrolyte disturbances in obese surgical candidates may indicate a tubulopathy.

Abstract

We present a case study of a 34‐year‐old man with morbid obesity and a suspected Bartter–Gitelman spectrum tubulopathy (without genetic confirmation), weighing 135 kg, and with a BMI of 42.5 kg/m2, who was referred to the metabolic and bariatric surgery department due to morbid obesity to address abnormal electrolyte levels. The clinical presentation suggested renal tubular salt wasting. Post‐sleeve gastrectomy, the patient had sustained and prolonged normalization in his electrolytes without the use of any medications. This provides evidence of a possible relationship between metabolic surgery and renal tubular function. This case supports recognizing a suspected tubulopathy in candidates for metabolic surgery.

This case underscores the importance of recognizing suspected Bartter–Gitelman spectrum tubulopathy in morbidly obese surgical candidates presenting with unexplained electrolyte disturbances.