Abstract
The occurrence of exaggerated natriuresis in response to volume expansion in hypertensive gravidas is controversial. In the present study, renal response to hypotonic saline infusion of 7 hypertensive pregnant women was compared to results of identical studies in normal gravidas. Additionally, the effect of changing from lateral to supine recumbency, a potent antinatriuretic maneuver, was evaluated. The hypertensive patients handled short-term saline loads in a manner similar to that observed in normotensive pregnant women, and changing posture resulted in a similar antinatriuretic effect in both groups. Thus, assessment of the natriuretic system by two different methods failed to demonstrate an exaggerated natriuresis in pregnant hypertensive women. Furthermore, patterns of solute and water excretion showed no evidence of impaired sodium handling at distal tubular sites, in contrast with observations in nonpregnant hypertensive women.
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