Metabolic alkalosis

Etiology

Saline-Responsive (U_Cl <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

Saline-Unresponsive (U_Cl >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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