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{{Infobox_Disease |
__NOTOC__
  Name          = {{PAGENAME}} |
{{Metabolic alkalosis}}
  Image          = |
'''For patient information, click [[Metabolic alkalosis (patient information)|here]]'''
  Caption        = |
  DiseasesDB    = 402 |
  ICD10          = {{ICD10|E|87|3|e|70}} |
  ICD9          = {{ICD9|276.3}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = |
  eMedicineTopic = |
  MeshID        = |
}}
{{SI}}
{{CMG}}
==Overview==
'''Metabolic alkalosis''' is an elevation of the pH in the bloodstream which results from decreased [[hydrogen]] ion concentration leading to increased [[bicarbonate]] and [[carbon dioxide]] concentrations, or alternatively a direct result of increased [[bicarbonate]] concentrations.


==Pathophysiology==
{{CMG}}; {{AE}} {{MMT}}


===Loss of hydrogen ions===
{{SK}}
====GI loss====
* [[Vomiting]] (excretion of hydrogen ions and the retention of bicarbonate)
* [[Nasogastric tube]] suction
====Renal====
* Over-diuresis
* [[Hyperaldosteronism]] causing retention of sodium followed with compensatory excretion of hydrogen
* Administration of non-resorbable anions such as, [[penicillin]], [[carbenicillin]], which complexs with positively-charged hydrogen ions in the renal tubules.


===Increase in the serum bicarbonate===
==[[Metabolic alkalosis overview|Overview]]==
* Ingestion of [[sodium bicarbonate]], baking soda, citrate, lactate, or acetate.
===Shift of hydrogen ions into intracellular space===
* Seen in [[hypokalemia]].  Due to a low extracellular potassium concentration, potassium shifts out of the cells, and in order to maintain electrical neutrality, hydrogen shifts into the cells, leaving behind bicarbonate.
===Contraction alkalosis===
* This results from a loss of water in the extracellular space which is poor in bicarbonate, typically from diuretic use.  Since water is lost while bicarbonate is retained, the concentration of bicarbonate increases.


===Compensation for Metabolic Alkalosis===
==[[Metabolic alkalosis historical perspective|Historical Perspective]]==
The body attempts to compensate for the increase in pH by retaining [[carbon dioxide]] (CO<sub>2</sub>) through [[hypoventilation]] ([[respiratory compensation]]). CO<sub>2</sub> combines with elements in the bloodstream to form carbonic acid, thus decreasing pH.


[[Renal compensation]] for metabolic alkalosis consists of increased excretion of HCO<sub>3</sub><sup>-</sup> (bicarbonate), because the filtered load of HCO<sub>3</sub><sup>-</sup> exceeds the ability of the renal tubule to reabsorb it.
==[[Metabolic alkalosis classification|Classification]]==


==Epidemiology and Demographics==
==[[Metabolic alkalosis pathophysiology|Pathophysiology]]==
It is the most common acid-base disorder seen in hospital in the United States.
==Differential diagnosis of metabolic alkalosis==
* [[Urine chloride]] is used to narrow down the differential diagnosis of [[metabolic alkalosis]].
===Low chloride===
* Low chloride defined as chloride levels <10mEq/dl and is found in conditions of volume depletions like:
** [[Vomiting]],
** [[Nasogastric tube]] suction, and
** Over diuresis.
* Other condition with similar presentation without volume depletion is [[hypercapnia]]
===Normal or high chloride level===
* Defined as chloride levels > 10mEQ/dL
* Normal chloride levels with hypertension
** Cushing's syndrome,
** Primary aldosteronism (Conn's syndrome), and
** Renal artery stenosis.
* Patients with renal failure who are given too much of supplemental alkali have similar presentation.


==References==
==[[Metabolic alkalosis  causes|Causes]]==
{{Reflist|2}}


[[Category:Nephrology]]
==[[Metabolic alkalosis differential diagnosis|Differentiating Metabolic alkalosis from other Diseases]]==
 
==[[Metabolic alkalosis epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Metabolic alkalosis risk factors|Risk Factors]]==
 
==[[Metabolic alkalosis screening|Screening]]==
 
==[[Metabolic alkalosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
[[Metabolic alkalosis diagnostic study of choice|Diagnostic study of choice]] | [[Metabolic alkalosis history and symptoms|History and Symptoms]] | [[Metabolic alkalosis physical examination|Physical Examination]] | [[Metabolic alkalosis laboratory findings|Laboratory Findings]] | [[Metabolic alkalosis electrocardiogram|Electrocardiogram]] | [[Metabolic alkalosis x ray|X-Ray Findings]] | [[Metabolic alkalosis echocardiography and ultrasound|Echocardiography and Ultrasound]] | [[Metabolic alkalosis CT scan|CT-Scan Findings]] | [[Metabolic alkalosis MRI|MRI Findings]] | [[Metabolic alkalosis other imaging findings|Other Imaging Findings]] | [[Metabolic alkalosis other diagnostic studies|Other Diagnostic Studies]]
 
==Treatment==
[[Metabolic alkalosis medical therapy|Medical Therapy]] | [[Metabolic alkalosis surgery|Surgery]] | [[Metabolic alkalosis primary prevention|Primary Prevention]] | [[Metabolic alkalosis secondary prevention|Secondary Prevention]] | [[Metabolic alkalosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Metabolic alkalosis future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
[[Metabolic alkalosis case study one|Case #1]]
 
==Related Chapters==
* [[Respiratory alkalosis]]
* [[Acid-base imbalance]]
* [[Metabolic acidosis]]
* [[Respiratory acidosis]]
* [[Anion gap]]
* [[Hypocalcemia]]
[[Category:Electrolyte disturbance]]
[[Category:Electrolyte disturbance]]
[[Category:Inborn errors of metabolism]]
[[Category:Inborn errors of metabolism]]
[[Category:Signs and symptoms]]
[[Category:Medical tests]]
 
[[Category:Laboratory Test]]
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Latest revision as of 07:38, 21 February 2021

Metabolic alkalosis Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Metabolic alkalosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

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Treatment

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Marufa Marium, M.B.B.S[2]

Synonyms and keywords:

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Metabolic alkalosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic study of choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-Ray Findings | Echocardiography and Ultrasound | CT-Scan Findings | MRI Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

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