DOI: 10.12890/2026_006821

Distal renal tubular acidosis in pregnancy: a case report and systematic literature review

Authors

  • Muhammad sabisi Department of Internal Medicine, School of Medicine Batam University/ Hj. Bunda Halimah Hospital, Batam, Indonesia 0009-0008-7035-5268
  • Erika Kusumawardani Department of Obstetrics and Gynecology, School of Medicine Batam University/ Hj. Bunda Halimah Hospital, Batam, Indonesia 0009-0009-2037-8565
  • Apriani Lam School of Medicine, Kristen Maranatha University, Bandung, Indonesia 0009-0004-3139-1339
  • Safira Putri School of Medicine, Airlangga University, Surabaya, Indonesia 0009-0001-1853-4663
  • Eric Fernando School of Medicine, Universitas Sumatera Utara, Medan, Indonesia 0000-0002-6903-5805

ali.s@univbatam.ac.id

Keywords

Distal renal tubular acidosis, pregnancy, hypokalaemia, metabolic acidosis

Abstract

Introduction: Distal renal tubular acidosis (dRTA) is a rare disorder characterized by normal anion gap metabolic acidosis and hypokalaemia. Physiological changes during pregnancy may aggravate acid-base imbalance and influence foetal outcomes.
Case description: A 40-year-old pregnant woman at 24-25 weeks of gestation presented with recurrent hypokalaemia and lower limb weakness. Laboratory findings showed normal anion gap metabolic acidosis, consistent with dRTA. The patient was treated with oral potassium supplementation and intravenous sodium bicarbonate, resulting in clinical improvement. In the third trimester, intrauterine growth restriction was identified. Delivery at term resulted in a live neonate with low birth weight.
A literature review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines using PubMed, ScienceDirect, Wiley Online Library, SpringerLink, and ResearchGate for studies published between 2016 and 2026. Ten case reports met the inclusion criteria. Distal RTA was the most frequently reported subtype, accounting for 80% of cases. Most cases (70%) were first diagnosed during pregnancy. The most common treatment strategy was potassium supplementation combined with bicarbonate therapy (90%), administered either orally, intravenously, or as combination therapy. Adverse neonatal outcomes were reported in 50% of cases.
Conclusion: Distal RTA should be considered in pregnant patients presenting with recurrent hypokalaemia and muscle weakness. Early recognition and appropriate correction of electrolyte imbalance and metabolic acidosis are essential to optimize maternal and foetal condition. Further studies are needed to better define clinical characteristics and management strategies of renal tubular acidosis during pregnancy.

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References

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Published

2026-05-19

Issue

Vol. 13 No. 6 (2026)

Categories

How to Cite

1.
sabisi M, Erika Kusumawardani, Apriani Lam, Putri S, Fernando E. Distal renal tubular acidosis in pregnancy: a case report and systematic literature review. EJCRIM [Internet]. 2026 May 19 [cited 2026 Nov. 3];13(6). Available from: https://ejcrim.com/index.php/ejcrim/article/view/6821