BACKGROUND: antenatal variant of Bartter syndrome is characterized by a history 
of polyhydramnios, premature birth, metabolic alkalosis, hypokalemia, polyuria 
and renal salt wasting. In this report we present a premature female baby with 
antenatal Barter syndrome who had three episodes of urinary tract infection 
(UTI), without evidence for congenital anomaly of the kidneys or urinary tract.
METHODS: antenatal Bartter syndrome was diagnosed according to the standard 
criteria. Ultrasound scan and voiding cystourethrography were performed to 
exclude congenital anomaly of the kidneys and urinary tract.
RESULTS: the baby presented with early hyperkalemia and acidosis. The typical 
biochemical features of the Bartter syndrome were observed in the second month. 
Despite appropriate treatment she had persistent hypercalciuria. The clinical 
course was complicated with recurrent episodes of febrile UTIs. Urinary tract 
system imaging did not demonstrate congenital anomalies. She finally died of 
severe dehydration, acidosis and renal failure.
CONCLUSION: since no congenital anomaly of the kidneys or urinary tract was 
demonstrated in our patient, we believe that severe, persistent hypercalciuria 
is the most important risk factor for development of recurrent UTIs.