KCNJ1

Several dozen mutations in the KCNJ1 gene have been identified in people with Bartter syndrome type II. This form of the disorder causes severe or life-threatening health problems that become apparent before or soon after birth.

Some of the KCNJ1 gene mutations responsible for Bartter syndrome change single protein building blocks (amino acids) in the ROMK protein. These mutations prevent the protein from reaching the cell membrane or alter the channel's ability to transport potassium ions. Other mutations in the KCNJ1 gene delete amino acids from the protein or lead to the production of an abnormally short, nonfunctional version of ROMK.

A loss of functional ROMK affects the normal activity of the NKCC2 protein, preventing it from transporting ions into kidney cells. As a result, the kidneys cannot reabsorb salt normally and excess salt is lost through the urine (salt wasting). The abnormal salt loss disrupts the normal balance of sodium, potassium, and other ions in the body. These imbalances underlie the major features of Bartter syndrome.

Studies suggest that normal variants (polymorphisms) in the KCNJ1 gene may help explain variations in blood pressure seen in different people. Certain rare polymorphisms appear to protect against high blood pressure (hypertension), and researchers speculate that other genetic variants might increase the risk of high blood pressure. Changes in the KCNJ1 gene may affect blood pressure by altering the kidneys' ability to reabsorb salt into the bloodstream.