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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 (<10mEq/dl)===
* 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===
==[[Metabolic alkalosis  causes|Causes]]==
* 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 differential diagnosis|Differentiating Metabolic alkalosis from other Diseases]]==
{{Reflist|2}}


[[Category:Nephrology]]
==[[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

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Diagnosis

Diagnostic Study of Choice

History and Symptoms

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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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