Metabolic Alkalosis

 

“Requires” a renal bicarbonate excretory defect:

 

Causes

Acid loss Bicarbonate intake

  • Gastric

  • Mineralcorticoid excess, hyperreninism

  • Posthypercapneic

  • Hypokalemia

  • Diuretics

  • Hypoparathyroidism

  • Massive blood transfusion

  • Bicarbonate (IV, PO)

 

 

Chloride classification

Saline (Cl) responsive (urine Cl <10) Saline (Cl) resistant (urine Cl >1)

  • Gastric losses

  • Diuretics

  • “Contraction alkalosis”

  • Mineralcorticoid excess

  • Hypokalemia

  • Posthypercapenic

  • Hypoparathyroidism

  • Bicarbonate administration