Transient Renal Tubular Acidosis in Pregnancy

Abstract

Renal tubular acidosis in pregnancy is a very rare disorder. Most cases are either inherited or secondary to maternal disease or ingestion of toxic chemicals. We report a 22-year-old woman, previously healthy, who presented at 27 weeks of gestation with preterm labor. Investigation revealed renal tubular acidosis with no obvious etiology. Labor was stopped with various tocolytic drugs and her electrolyte imbalance was corrected. She was delivered at 36 weeks, by cesarean for a nonreassuring fetal heart tracing, of an appropriate-for-gestational-age infant weighing 2905 g. Evaluation 3 and 6 months postpartum revealed gradual, but complete resolution of the acidosis and electrolyte abnormality. The infant is now 7 months old, is growing normally with normal electrolytes, and with no evidence of acidosis.

Hypokalemic Paraplegia in Pregnancy

“…The rennin-angiotensinaldosterone axis was normal, so also the urinary calcium levels, hence Bartter's syndrome [4], Gittleman syndrome [5] and Bartter like conditions were ruled out. There was no metabolic acidosis and renal function tests were normal, not suggestive of distal or proximal renal tubular acidosis [6][7][8][9][10]. There was no history of pica in this lady to suggest ingestion of any unusual substance [11].…”

Renal Tubular Acidosis: An Uncommon Cause of Bad Obstetric History

“…RTA has been shown to have detrimental effect on both the maternal and fetal wellbeing. A majority of the patients present with preterm labor [2]. It has been demonstrated that the blood flow to the pregnant uterus is decreased, and this may be potentially associated with fetal distress [4].…”

“…Renal tubular acidosis (RTA) is one such clinical entity arising out of altered tubular function commonly as a manifestation of various systemic diseases. In pregnancy, it has also been reported occasionally as a transient phenomenon without any apparent etiology [2]. This entity, although very rare in pregnancy [3], has been shown to be associated with adverse maternal and fetal outcomes [2].…”

“…In pregnancy, it has also been reported occasionally as a transient phenomenon without any apparent etiology [2]. This entity, although very rare in pregnancy [3], has been shown to be associated with adverse maternal and fetal outcomes [2]. Early recognition and action to redress the same can help in achieving optimum outcome.…”

Proximal Renal Tubular Acidosis in Pregnancy

“…The renal disease was usually associated with a systemic disorder such as diabetes mellitus, chronic active hepatitis or SLE. RTA may also be transient with no obvious aetiology and show complete resolution following delivery [9] . RTA due to maternal substance abuse has been associated with foetal growth retardation, pre-term labour, dysmorphic features and perinatal death [10,11] .…”