Metabolic alkalosis

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Saline-Responsive (UCl <10 meq/d)Excessive body bicarbonate content

  • Renal alkalosis
    • Diuretic therapy
    • Poorly reabsorbable anion therapy: carbenicillin, penicillin, sulfate, phosphate
    • Posthypercapnia
  • Gastrointestinal alkalosis
    • Loss of HCl from vomiting or nasogastric suction
    • Intestinal alkalosis: chloride diarrhea
  • Exogenous alkali
    • NaHCO3 (baking soda)
    • Sodium citrate, lactate, gluconate, acetate
    • Transfusions
    • Antacids
Normal body bicarbonate content
  • Contraction alkalosis
Saline-Unresponsive (UCl >10 meq/d)Excessive body bicarbonate content
  • Renal alkalosis, Normotensive
    • Bartter's syndrome (renal salt wasting and secondary hyperaldosteronism)
    • Severe potassium depletion
    • Refeeding alkalosis
    • Hypercalcemia and hypoparathyroidism
  • Renal alkalosis, Hypertensive
    • Endogenous mineralocorticoids
      • Primary aldosteronism
      • Hyperreninism
      • Adrenal enzyme deficiency: 11- and 17-hydroxylase
      • Liddle's syndrome
    • Exogenous mineralocorticoids
      • European licorice

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Last updated: December 1, 2014