Common Causes of Metabolic Alkalosis

In this article, we will discuss various Common Causes of Metabolic Alkalosis. So, let’s get started.


1. Saline-responsive (normotensive extra-cellular volume contraction and hypokalemia)

A. Excessive body bicarbonate content

i. Renal alkalosis

  • Diuretic therapy
  • Drugs, e.g. carbenicillin, penicillin, sulphate, phosphate
  • Posthypercapnia

ii. Gastrointestinal alkalosis

  • Vomiting or nasogastric aspirations
  • Diarrhea (chloride loss)
  • Sodium citrate, lactate, gluconate, acetate
  • Transfusions
  • Antacids

B. Normal body bicarbonate content

  • Contraction alkalosis

2. Saline-unresponsive (normotensive or hypertensive normovolemia or hypervolemia)

A. Excessive body bicarbonate content

i. Normotensive

  • Severe potassium depletion
  • Bartter syndrome
  • Refeeding alkalosis
  • Hypercalcemic and hypoparathyroidism

ii. Hypertensive

  • Hyper-reninism, primary aldosteronism
  • Liddle syndrome
  • Exogenous alkali
  • Exogenous mineralocorticoids
  • Liquorice use

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