Pregnancy and renal tubular acidosis

Renal tubular acidosis (RTA) is uncommonly encountered in pregnancy. The ri sk for these women to develop pregnancy-induced hypertension has not been p reviously described. The renal defect noted in these women, aggravated by t he normal hypervolemia of pregnancy, may predispose to hypertension. Three pregnancies in two women with RTA type 1 developed persistent diastolic hyp ertension in the third trimester. Mild renal insufficiency was noted in eac h woman as defined by serum creatinine of 0.9-1.1 and 1.4-1.6 mg/dL, respec tively. Vaginal delivery was achieved in each without complications. Blood pressures returned to normal following each pregnancy. Pregnancy-induced hy pertension developed in each of three pregnancies in two patients with RTA type 1. The risk for these women to develop pregnancy-induced hypertension may be associated with the higher reported risk in women with underlying re nal disease.