II. Types
- Chloride responsive Metabolic Alkalosis
- Extracellular fluid contraction
- Saline responsive
- Chloride-resistant Metabolic Alkalosis
- Associated with excess mineralocorticoid
- Associated with Hypokalemia
- Saline unresponsive
III. Causes: Low Urine Chloride <10 meq/L
- Gastrointestinal causes
- Renal Causes
- Diuretic use (Urine Chloride >10 meq/L)
- Poorly reabsorbable anion
- Carbenicillin
- Penicillin
- Sulfate
- Phsophate
- Post-Hypercapnia
- Exogenous alkali
- Sodium Bicarbonate (baking soda)
- Sodium Citrate
- Lactate
- Gluconate
- Acetate
- Transfusion
- Antacid
- Cystic Fibrosis
- Achlorhydria
- Contraction alkalosis
IV. Causes: Normal or High Urine Chloride >20 meq/L
- Hypertensive Patient
- Adrenal Disease
- Primary Hyperaldosteronism
- Cushing's Syndrome (Pituitary, Adrenal or ectopic)
- Liddle Syndrome
- Exogenous steroids
- Excess mineralocorticoid intake
- Excess Glucocorticoid intake
- Excessive licorice intake
- Carbenoxalone
- Glycyrrhizic acid
- Chewing Tobacco
- Adrenal Disease
- Normotensive Patient
- Bartter Syndrome or Gitelman Syndrome
- Hypokalemia
- Excessive alkali administration
- Milk-Alkali Syndrome
- Refeeding alkalosis
V. Labs
-
Arterial Blood Gas
- Arterial pH increased
- Serum bicarbonate increased
- PaCO2 increased
- Excess Anion Gap >30 mEq/L
-
Urine Chloride
- See Above
VI. References
- Arieff (1993) J Crit Illn 8(2): 224-46 [PubMed]
- Narins (1982) Am J Med 72:496 [PubMed]
- Narins (1980) Medicine 59:161-95 [PubMed]
- Ghosh (2000) Fed Pract p. 23-33
- Rutecki (Dec 1997) Consultant, p. 3067-74
- Rutecki (Jan 1998) Consultant, p. 131-42
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Related Studies
Definition (NCI) | Abnormally increased pH levels in the blood due to excessive loss of acid and/or accumulation of base. |
Concepts | Disease or Syndrome (T047) |
ICD10 | E87.3 |
SnomedCT | 1388004 |
English | ALKALOSIS METABOLIC, metabolic alkalosis, metabolic alkalosis (diagnosis), Alkalosis metabolic, Metabolic alkaloses, metabolic alkaloses, alkalosis metabolic, disorder metabolic alkalosis, Metabolic Alkalosis, Metabolic alkalosis, Metabolic alkalosis (disorder) |
Italian | Alcalosi metabolica, Alcalosi metaboliche |
German | Alkalose metabolisch, ALKALOSE METABOLISCH, Metabolische Alkalosen, metabolische Alkalose |
Japanese | 代謝性アルカローシス, タイシャセイアルカローシス |
Portuguese | ALCALOSE METABOLICA, Alcalose metabólica, Alcaloses metabólicas |
French | ALCALOSE METABOLIQUE, Alcalose métabolique, Alcaloses métaboliques |
Spanish | ALCALOSIS METABOLICA, alcalosis metabólica (trastorno), alcalosis metabólica, Alcalosis metabólicas, Alcalosis metabólica |
Czech | Metabolické alkalózy, Metabolická alkalóza |
Hungarian | Anyagcsere alkalosisok, Metabolikus alkalosis, Metabolicus alkalosis |
Dutch | metabole alkalosen, metabole alkalose |