Alkalosis: Difference between revisions
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! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | ! rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | ||
! colspan="2" rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | ! colspan="2" rowspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | ||
! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical | ! colspan="6" align="center" style="background:#4479BA; color: #FFFFFF;" + |Clinical | ||
! colspan="12" align="center" style="background:#4479BA; color: #FFFFFF;" + |Paraclinical | ! colspan="12" align="center" style="background:#4479BA; color: #FFFFFF;" + |Paraclinical | ||
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! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal function | ! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal function | ||
|- | |- | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | ||
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! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Exogenous HCO<sub><big>3</big></sub><sup>−</sup> loads | ! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Exogenous HCO<sub><big>3</big></sub><sup>−</sup> loads | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Acute alkali administration<ref name="MáttarWeil1974">{{cite journal|last1=Máttar|first1=João A.|last2=Weil|first2=Max Harry|last3=Shubin|first3=Herbert|last4=Stein|first4=Leon|title=Cardiac arrest in the critically III|journal=The American Journal of Medicine|volume=56|issue=2|year=1974|pages=162–168|issn=00029343|doi=10.1016/0002-9343(74)90593-2}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |Acute alkali administration<ref name="MáttarWeil1974">{{cite journal|last1=Máttar|first1=João A.|last2=Weil|first2=Max Harry|last3=Shubin|first3=Herbert|last4=Stein|first4=Leon|title=Cardiac arrest in the critically III|journal=The American Journal of Medicine|volume=56|issue=2|year=1974|pages=162–168|issn=00029343|doi=10.1016/0002-9343(74)90593-2}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Milk-alkali syndrome|Milk−alkali syndrome]]<ref name="Abreo1993">{{cite journal|last1=Abreo|first1=Kenneth|title=The Milk-Alkali Syndrome|journal=Archives of Internal Medicine|volume=153|issue=8|year=1993|pages=1005|issn=0003-9926|doi=10.1001/archinte.1993.00410080065011}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Milk-alkali syndrome|Milk−alkali syndrome]]<ref name="Abreo1993">{{cite journal|last1=Abreo|first1=Kenneth|title=The Milk-Alkali Syndrome|journal=Archives of Internal Medicine|volume=153|issue=8|year=1993|pages=1005|issn=0003-9926|doi=10.1001/archinte.1993.00410080065011}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Transfusion]]<ref name="pmid14712429">{{cite journal |vauthors=Gupta M, Wadhwa NK, Bukovsky R |title=Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate |journal=Am. J. Kidney Dis. |volume=43 |issue=1 |pages=67–73 |date=January 2004 |pmid=14712429 |doi= |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Transfusion]]<ref name="pmid14712429">{{cite journal |vauthors=Gupta M, Wadhwa NK, Bukovsky R |title=Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate |journal=Am. J. Kidney Dis. |volume=43 |issue=1 |pages=67–73 |date=January 2004 |pmid=14712429 |doi= |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |± | | align="center" style="background:#F5F5F5;" + |± | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Penicillin]]<ref name="ZakiLad2011">{{cite journal|last1=Zaki|first1=SyedAhmed|last2=Lad|first2=Vijay|title=Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis|journal=Indian Journal of Pharmacology|volume=43|issue=5|year=2011|pages=609|issn=0253-7613|doi=10.4103/0253-7613.84986}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Penicillin]]<ref name="ZakiLad2011">{{cite journal|last1=Zaki|first1=SyedAhmed|last2=Lad|first2=Vijay|title=Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis|journal=Indian Journal of Pharmacology|volume=43|issue=5|year=2011|pages=609|issn=0253-7613|doi=10.4103/0253-7613.84986}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Licorice<ref name="MeltemFigen2009">{{cite journal|last1=Meltem|first1=Akkas Camkurt|last2=Figen|first2=Coskun|last3=Nalan|first3=Metin Aksu|last4=Mahir|first4=Kunt|last5=Sebnem|first5=Bozkurt|last6=Mehlika|first6=Isildak|last7=Kasim|first7=Kilic Ahmet|last8=Miyase|first8=Bayraktar|title=A hypokalemic muscular weakness after licorice ingestion: a case report|journal=Cases Journal|volume=2|issue=1|year=2009|pages=8053|issn=1757-1626|doi=10.4076/1757-1626-2-8053}}</ref><ref name="LinYang2003">{{cite journal|last1=Lin|first1=Shih-Hua|last2=Yang|first2=Sung-Sen|last3=Chau|first3=Tom|last4=Halperin|first4=Mitchell L.|title=An Unusual Cause of Hypokalemic Paralysis: Chronic Licorice Ingestion|journal=The American Journal of the Medical Sciences|volume=325|issue=3|year=2003|pages=153–156|issn=00029629|doi=10.1097/00000441-200303000-00008}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |Licorice<ref name="MeltemFigen2009">{{cite journal|last1=Meltem|first1=Akkas Camkurt|last2=Figen|first2=Coskun|last3=Nalan|first3=Metin Aksu|last4=Mahir|first4=Kunt|last5=Sebnem|first5=Bozkurt|last6=Mehlika|first6=Isildak|last7=Kasim|first7=Kilic Ahmet|last8=Miyase|first8=Bayraktar|title=A hypokalemic muscular weakness after licorice ingestion: a case report|journal=Cases Journal|volume=2|issue=1|year=2009|pages=8053|issn=1757-1626|doi=10.4076/1757-1626-2-8053}}</ref><ref name="LinYang2003">{{cite journal|last1=Lin|first1=Shih-Hua|last2=Yang|first2=Sung-Sen|last3=Chau|first3=Tom|last4=Halperin|first4=Mitchell L.|title=An Unusual Cause of Hypokalemic Paralysis: Chronic Licorice Ingestion|journal=The American Journal of the Medical Sciences|volume=325|issue=3|year=2003|pages=153–156|issn=00029629|doi=10.1097/00000441-200303000-00008}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Laxative abuse]]<ref name="RoerigSteffen2010">{{cite journal|last1=Roerig|first1=James L.|last2=Steffen|first2=Kristine J.|last3=Mitchell|first3=James E.|last4=Zunker|first4=Christie|title=Laxative Abuse|journal=Drugs|volume=70|issue=12|year=2010|pages=1487–1503|issn=0012-6667|doi=10.2165/11898640-000000000-00000}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Laxative abuse]]<ref name="RoerigSteffen2010">{{cite journal|last1=Roerig|first1=James L.|last2=Steffen|first2=Kristine J.|last3=Mitchell|first3=James E.|last4=Zunker|first4=Christie|title=Laxative Abuse|journal=Drugs|volume=70|issue=12|year=2010|pages=1487–1503|issn=0012-6667|doi=10.2165/11898640-000000000-00000}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
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* Aluminum hydroxide | * Aluminum hydroxide | ||
* Sodium polystyrene sulfonate | * Sodium polystyrene sulfonate | ||
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! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gastrointestinal origin | ! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Gastrointestinal origin | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Vomiting]]<ref name="GanMeyer2003">{{cite journal|last1=Gan|first1=Tong J.|last2=Meyer|first2=Tricia|last3=Apfel|first3=Christian C.|last4=Chung|first4=Frances|last5=Davis|first5=Peter J.|last6=Eubanks|first6=Steve|last7=Kovac|first7=Anthony|last8=Philip|first8=Beverly K.|last9=Sessler|first9=Daniel I.|last10=Temo|first10=James|last11=Tram??r|first11=Martin R.|last12=Watcha|first12=Mehernoor|title=Consensus Guidelines for Managing Postoperative Nausea and Vomiting|journal=Anesthesia & Analgesia|year=2003|pages=62–71|issn=0003-2999|doi=10.1213/01.ANE.0000068580.00245.95}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Vomiting]]<ref name="GanMeyer2003">{{cite journal|last1=Gan|first1=Tong J.|last2=Meyer|first2=Tricia|last3=Apfel|first3=Christian C.|last4=Chung|first4=Frances|last5=Davis|first5=Peter J.|last6=Eubanks|first6=Steve|last7=Kovac|first7=Anthony|last8=Philip|first8=Beverly K.|last9=Sessler|first9=Daniel I.|last10=Temo|first10=James|last11=Tram??r|first11=Martin R.|last12=Watcha|first12=Mehernoor|title=Consensus Guidelines for Managing Postoperative Nausea and Vomiting|journal=Anesthesia & Analgesia|year=2003|pages=62–71|issn=0003-2999|doi=10.1213/01.ANE.0000068580.00245.95}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |± | | align="center" style="background:#F5F5F5;" + |± | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Nasogastric tube suction<ref name="GilbertsonRogers2011">{{cite journal|last1=Gilbertson|first1=Heather Ruth|last2=Rogers|first2=Elizabeth Jessie|last3=Ukoumunne|first3=Obioha Chukwunyere|title=Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement|journal=Journal of Parenteral and Enteral Nutrition|volume=35|issue=4|year=2011|pages=540–544|issn=0148-6071|doi=10.1177/0148607110383285}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |Nasogastric tube suction<ref name="GilbertsonRogers2011">{{cite journal|last1=Gilbertson|first1=Heather Ruth|last2=Rogers|first2=Elizabeth Jessie|last3=Ukoumunne|first3=Obioha Chukwunyere|title=Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement|journal=Journal of Parenteral and Enteral Nutrition|volume=35|issue=4|year=2011|pages=540–544|issn=0148-6071|doi=10.1177/0148607110383285}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Zollinger-Ellison syndrome|Zollinger−Ellison syndrome]]<ref name="HungSchubert2003">{{cite journal|last1=Hung|first1=Patrick D.|last2=Schubert|first2=Mitchell L.|last3=Mihas|first3=Anastasios A.|title=Zollinger-Ellison syndrome|journal=Current Treatment Options in Gastroenterology|volume=6|issue=2|year=2003|pages=163–170|issn=1092-8472|doi=10.1007/s11938-003-0017-6}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Zollinger-Ellison syndrome|Zollinger−Ellison syndrome]]<ref name="HungSchubert2003">{{cite journal|last1=Hung|first1=Patrick D.|last2=Schubert|first2=Mitchell L.|last3=Mihas|first3=Anastasios A.|title=Zollinger-Ellison syndrome|journal=Current Treatment Options in Gastroenterology|volume=6|issue=2|year=2003|pages=163–170|issn=1092-8472|doi=10.1007/s11938-003-0017-6}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Bulimia nervosa]]<ref name="ShapiroBerkman2007">{{cite journal|last1=Shapiro|first1=Jennifer R.|last2=Berkman|first2=Nancy D.|last3=Brownley|first3=Kimberly A.|last4=Sedway|first4=Jan A.|last5=Lohr|first5=Kathleen N.|last6=Bulik|first6=Cynthia M.|title=Bulimia nervosa treatment: A systematic review of randomized controlled trials|journal=International Journal of Eating Disorders|volume=40|issue=4|year=2007|pages=321–336|issn=02763478|doi=10.1002/eat.20372}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Bulimia nervosa]]<ref name="ShapiroBerkman2007">{{cite journal|last1=Shapiro|first1=Jennifer R.|last2=Berkman|first2=Nancy D.|last3=Brownley|first3=Kimberly A.|last4=Sedway|first4=Jan A.|last5=Lohr|first5=Kathleen N.|last6=Bulik|first6=Cynthia M.|title=Bulimia nervosa treatment: A systematic review of randomized controlled trials|journal=International Journal of Eating Disorders|volume=40|issue=4|year=2007|pages=321–336|issn=02763478|doi=10.1002/eat.20372}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Congenital chloridorrhea<ref name="WedenojaHãGlund2010">{{cite journal|last1=Wedenoja|first1=S.|last2=HãGlund|first2=P.|last3=Holmberg|first3=C.|title=Review article: the clinical management of congenital chloride diarrhoea|journal=Alimentary Pharmacology & Therapeutics|volume=31|issue=4|year=2010|pages=477–485|issn=02692813|doi=10.1111/j.1365-2036.2009.04197.x}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |Congenital chloridorrhea<ref name="WedenojaHãGlund2010">{{cite journal|last1=Wedenoja|first1=S.|last2=HãGlund|first2=P.|last3=Holmberg|first3=C.|title=Review article: the clinical management of congenital chloride diarrhoea|journal=Alimentary Pharmacology & Therapeutics|volume=31|issue=4|year=2010|pages=477–485|issn=02692813|doi=10.1111/j.1365-2036.2009.04197.x}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Pyloric stenosis]]<ref name="BakalSarac2016">{{cite journal|last1=Bakal|first1=Unal|last2=Sarac|first2=Mehmet|last3=Aydin|first3=Mustafa|last4=Tartar|first4=Tugay|last5=Kazez|first5=Ahmet|title=Recent changes in the features of hypertrophic pyloric stenosis|journal=Pediatrics International|volume=58|issue=5|year=2016|pages=369–371|issn=13288067|doi=10.1111/ped.12860}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Pyloric stenosis]]<ref name="BakalSarac2016">{{cite journal|last1=Bakal|first1=Unal|last2=Sarac|first2=Mehmet|last3=Aydin|first3=Mustafa|last4=Tartar|first4=Tugay|last5=Kazez|first5=Ahmet|title=Recent changes in the features of hypertrophic pyloric stenosis|journal=Pediatrics International|volume=58|issue=5|year=2016|pages=369–371|issn=13288067|doi=10.1111/ped.12860}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Villous adenoma]]<ref name="GennariWeise2008">{{cite journal|last1=Gennari|first1=F. J.|last2=Weise|first2=W. J.|title=Acid-Base Disturbances in Gastrointestinal Disease|journal=Clinical Journal of the American Society of Nephrology|volume=3|issue=6|year=2008|pages=1861–1868|issn=1555-9041|doi=10.2215/CJN.02450508}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Villous adenoma]]<ref name="GennariWeise2008">{{cite journal|last1=Gennari|first1=F. J.|last2=Weise|first2=W. J.|title=Acid-Base Disturbances in Gastrointestinal Disease|journal=Clinical Journal of the American Society of Nephrology|volume=3|issue=6|year=2008|pages=1861–1868|issn=1555-9041|doi=10.2215/CJN.02450508}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |Gastrocystoplasty<ref name="KurzrockBaskin1998">{{cite journal|last1=Kurzrock|first1=Eric A.|last2=Baskin|first2=Laurence S.|last3=Kogan|first3=Barry A.|title=GASTROCYSTOPLASTY: LONG-TERM FOLLOWUP|journal=The Journal of Urology|volume=160|issue=6|year=1998|pages=2182–2186|issn=00225347|doi=10.1016/S0022-5347(01)62289-4}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |Gastrocystoplasty<ref name="KurzrockBaskin1998">{{cite journal|last1=Kurzrock|first1=Eric A.|last2=Baskin|first2=Laurence S.|last3=Kogan|first3=Barry A.|title=GASTROCYSTOPLASTY: LONG-TERM FOLLOWUP|journal=The Journal of Urology|volume=160|issue=6|year=1998|pages=2182–2186|issn=00225347|doi=10.1016/S0022-5347(01)62289-4}}</ref> | ||
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! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | ||
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | ||
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! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal origin | ! rowspan="8" align="center" style="background:#4479BA; color: #FFFFFF;" + |Renal origin | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |Posthypercapnic state<ref name="BangaKhilnani2009">{{cite journal|last1=Banga|first1=Amit|last2=Khilnani|first2=G. C.|title=Post-hypercapnic Alkalosis is Associated with Ventilator Dependence and Increased ICU stay|journal=COPD: Journal of Chronic Obstructive Pulmonary Disease|volume=6|issue=6|year=2009|pages=437–440|issn=1541-2555|doi=10.3109/15412550903341448}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |Posthypercapnic state<ref name="BangaKhilnani2009">{{cite journal|last1=Banga|first1=Amit|last2=Khilnani|first2=G. C.|title=Post-hypercapnic Alkalosis is Associated with Ventilator Dependence and Increased ICU stay|journal=COPD: Journal of Chronic Obstructive Pulmonary Disease|volume=6|issue=6|year=2009|pages=437–440|issn=1541-2555|doi=10.3109/15412550903341448}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hypomagnesemia]]<ref name="pmid9252977">{{cite journal |vauthors=Elisaf M, Milionis H, Siamopoulos KC |title=Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics |journal=Miner Electrolyte Metab |volume=23 |issue=2 |pages=105–12 |date=1997 |pmid=9252977 |doi= |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hypomagnesemia]]<ref name="pmid9252977">{{cite journal |vauthors=Elisaf M, Milionis H, Siamopoulos KC |title=Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics |journal=Miner Electrolyte Metab |volume=23 |issue=2 |pages=105–12 |date=1997 |pmid=9252977 |doi= |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hypokalemia]]<ref name="pmid10665945">{{cite journal |vauthors=Galla JH |title=Metabolic alkalosis |journal=J. Am. Soc. Nephrol. |volume=11 |issue=2 |pages=369–75 |date=February 2000 |pmid=10665945 |doi= |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Hypokalemia]]<ref name="pmid10665945">{{cite journal |vauthors=Galla JH |title=Metabolic alkalosis |journal=J. Am. Soc. Nephrol. |volume=11 |issue=2 |pages=369–75 |date=February 2000 |pmid=10665945 |doi= |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + |− | | align="center" style="background:#F5F5F5;" + |− | ||
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|- | |- | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Bartter's syndrome]]<ref name="SimonKaret1996">{{cite journal|last1=Simon|first1=David B.|last2=Karet|first2=Fiona E.|last3=Hamdan|first3=Jahed M.|last4=Pietro|first4=Antonio Di|last5=Sanjad|first5=Sami A.|last6=Lifton|first6=Richard P.|title=Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na–K–2CI cotransporter NKCC2|journal=Nature Genetics|volume=13|issue=2|year=1996|pages=183–188|issn=1061-4036|doi=10.1038/ng0696-183}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Bartter's syndrome]]<ref name="SimonKaret1996">{{cite journal|last1=Simon|first1=David B.|last2=Karet|first2=Fiona E.|last3=Hamdan|first3=Jahed M.|last4=Pietro|first4=Antonio Di|last5=Sanjad|first5=Sami A.|last6=Lifton|first6=Richard P.|title=Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na–K–2CI cotransporter NKCC2|journal=Nature Genetics|volume=13|issue=2|year=1996|pages=183–188|issn=1061-4036|doi=10.1038/ng0696-183}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Gitelman syndrome|Gitelman’s syndrome]]<ref name="FremontChan2012">{{cite journal|last1=Fremont|first1=Oliver T.|last2=Chan|first2=James C. M.|title=Understanding Bartter syndrome and Gitelman syndrome|journal=World Journal of Pediatrics|volume=8|issue=1|year=2012|pages=25–30|issn=1708-8569|doi=10.1007/s12519-012-0333-9}}</ref><ref name="pmid7700218">{{cite journal |vauthors=Colussi G, Macaluso M, Brunati C, Minetti L |title=Calcium metabolism and calciotropic hormone levels in Gitelman's syndrome |journal=Miner Electrolyte Metab |volume=20 |issue=5 |pages=294–301 |date=1994 |pmid=7700218 |doi= |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Gitelman syndrome|Gitelman’s syndrome]]<ref name="FremontChan2012">{{cite journal|last1=Fremont|first1=Oliver T.|last2=Chan|first2=James C. M.|title=Understanding Bartter syndrome and Gitelman syndrome|journal=World Journal of Pediatrics|volume=8|issue=1|year=2012|pages=25–30|issn=1708-8569|doi=10.1007/s12519-012-0333-9}}</ref><ref name="pmid7700218">{{cite journal |vauthors=Colussi G, Macaluso M, Brunati C, Minetti L |title=Calcium metabolism and calciotropic hormone levels in Gitelman's syndrome |journal=Miner Electrolyte Metab |volume=20 |issue=5 |pages=294–301 |date=1994 |pmid=7700218 |doi= |url=}}</ref> | ||
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| Line 761: | Line 672: | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal artery stenosis]]<ref name="SafianTextor2001">{{cite journal|last1=Safian|first1=Robert D.|last2=Textor|first2=Stephen C.|title=Renal-Artery Stenosis|journal=New England Journal of Medicine|volume=344|issue=6|year=2001|pages=431–442|issn=0028-4793|doi=10.1056/NEJM200102083440607}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal artery stenosis]]<ref name="SafianTextor2001">{{cite journal|last1=Safian|first1=Robert D.|last2=Textor|first2=Stephen C.|title=Renal-Artery Stenosis|journal=New England Journal of Medicine|volume=344|issue=6|year=2001|pages=431–442|issn=0028-4793|doi=10.1056/NEJM200102083440607}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Liddle's syndrome|Liddle syndrome]]<ref name="SalihGautschi2017">{{cite journal|last1=Salih|first1=Mahdi|last2=Gautschi|first2=Ivan|last3=van Bemmelen|first3=Miguel X.|last4=Di Benedetto|first4=Michael|last5=Brooks|first5=Alice S.|last6=Lugtenberg|first6=Dorien|last7=Schild|first7=Laurent|last8=Hoorn|first8=Ewout J.|title=A Missense Mutation in the Extracellular Domain ofαENaC Causes Liddle Syndrome|journal=Journal of the American Society of Nephrology|volume=28|issue=11|year=2017|pages=3291–3299|issn=1046-6673|doi=10.1681/ASN.2016111163}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Liddle's syndrome|Liddle syndrome]]<ref name="SalihGautschi2017">{{cite journal|last1=Salih|first1=Mahdi|last2=Gautschi|first2=Ivan|last3=van Bemmelen|first3=Miguel X.|last4=Di Benedetto|first4=Michael|last5=Brooks|first5=Alice S.|last6=Lugtenberg|first6=Dorien|last7=Schild|first7=Laurent|last8=Hoorn|first8=Ewout J.|title=A Missense Mutation in the Extracellular Domain ofαENaC Causes Liddle Syndrome|journal=Journal of the American Society of Nephrology|volume=28|issue=11|year=2017|pages=3291–3299|issn=1046-6673|doi=10.1681/ASN.2016111163}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal cell carcinoma|Renal tumors]]<ref name="LasseigneBrooks2018">{{cite journal|last1=Lasseigne|first1=Brittany N.|last2=Brooks|first2=James D.|title=The Role of DNA Methylation in Renal Cell Carcinoma|journal=Molecular Diagnosis & Therapy|year=2018|issn=1177-1062|doi=10.1007/s40291-018-0337-9}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Renal cell carcinoma|Renal tumors]]<ref name="LasseigneBrooks2018">{{cite journal|last1=Lasseigne|first1=Brittany N.|last2=Brooks|first2=James D.|title=The Role of DNA Methylation in Renal Cell Carcinoma|journal=Molecular Diagnosis & Therapy|year=2018|issn=1177-1062|doi=10.1007/s40291-018-0337-9}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Endocrine | ! rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Endocrine | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cushing's syndrome]]<ref name="Araujo CastroMarazuela Azpiroz2018">{{cite journal|last1=Araujo Castro|first1=Marta|last2=Marazuela Azpiroz|first2=Mónica|title=Two types of ectopic Cushing syndrome or a continuum? Review|journal=Pituitary|year=2018|issn=1386-341X|doi=10.1007/s11102-018-0894-2}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cushing's syndrome]]<ref name="Araujo CastroMarazuela Azpiroz2018">{{cite journal|last1=Araujo Castro|first1=Marta|last2=Marazuela Azpiroz|first2=Mónica|title=Two types of ectopic Cushing syndrome or a continuum? Review|journal=Pituitary|year=2018|issn=1386-341X|doi=10.1007/s11102-018-0894-2}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Hyperaldosteronism]] | ! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Hyperaldosteronism]] | ||
! align="center" style="background:#DCDCDC;" + |[[Primary hyperaldosteronism|Primary]]<ref name="Martell-ClarosAbad-Cardiel2015">{{cite journal|last1=Martell-Claros|first1=Nieves|last2=Abad-Cardiel|first2=María|last3=Alvarez-Alvarez|first3=Beatriz|last4=García-Donaire|first4=José A.|last5=Pérez|first5=Cristina Fernández|title=Primary aldosteronism and its various clinical scenarios|journal=Journal of Hypertension|volume=33|issue=6|year=2015|pages=1226–1232|issn=0263-6352|doi=10.1097/HJH.0000000000000546}}</ref> | ! align="center" style="background:#DCDCDC;" + |[[Primary hyperaldosteronism|Primary]]<ref name="Martell-ClarosAbad-Cardiel2015">{{cite journal|last1=Martell-Claros|first1=Nieves|last2=Abad-Cardiel|first2=María|last3=Alvarez-Alvarez|first3=Beatriz|last4=García-Donaire|first4=José A.|last5=Pérez|first5=Cristina Fernández|title=Primary aldosteronism and its various clinical scenarios|journal=Journal of Hypertension|volume=33|issue=6|year=2015|pages=1226–1232|issn=0263-6352|doi=10.1097/HJH.0000000000000546}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! align="center" style="background:#DCDCDC;" + |[[Secondary hyperaldosteronism|Secondary]]<ref name="pmid29758100">{{cite journal |vauthors=Monticone S, Losano I, Tetti M, Buffolo F, Veglio F, Mulatero P |title=Diagnostic approach to low renin hypertension |journal=Clin. Endocrinol. (Oxf) |volume= |issue= |pages= |date=May 2018 |pmid=29758100 |doi=10.1111/cen.13741 |url=}}</ref> | ! align="center" style="background:#DCDCDC;" + |[[Secondary hyperaldosteronism|Secondary]]<ref name="pmid29758100">{{cite journal |vauthors=Monticone S, Losano I, Tetti M, Buffolo F, Veglio F, Mulatero P |title=Diagnostic approach to low renin hypertension |journal=Clin. Endocrinol. (Oxf) |volume= |issue= |pages= |date=May 2018 |pmid=29758100 |doi=10.1111/cen.13741 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Congenital adrenal hyperplasia]] | ! rowspan="2" align="center" style="background:#DCDCDC;" + |[[Congenital adrenal hyperplasia]] | ||
! align="center" style="background:#DCDCDC;" + |[[11β-hydroxylase deficiency|11β−Hydroxylase deficiency]]<ref name="pmid29626607">{{cite journal |vauthors=Baş F, Toksoy G, Ergun-Longmire B, Uyguner ZO, Abalı ZY, Poyrazoğlu Ş, Karaman V, Avcı Ş, Altunoğlu U, Bundak R, Karaman B, Başaran S, Darendeliler F |title=Prevalence, clinical characteristics and long-term outcomes of classical 11 β-hydroxylase deficiency (11BOHD) in Turkish population and novel mutations in CYP11B1 gene |journal=J. Steroid Biochem. Mol. Biol. |volume= |issue= |pages= |date=April 2018 |pmid=29626607 |doi=10.1016/j.jsbmb.2018.04.001 |url=}}</ref> | ! align="center" style="background:#DCDCDC;" + |[[11β-hydroxylase deficiency|11β−Hydroxylase deficiency]]<ref name="pmid29626607">{{cite journal |vauthors=Baş F, Toksoy G, Ergun-Longmire B, Uyguner ZO, Abalı ZY, Poyrazoğlu Ş, Karaman V, Avcı Ş, Altunoğlu U, Bundak R, Karaman B, Başaran S, Darendeliler F |title=Prevalence, clinical characteristics and long-term outcomes of classical 11 β-hydroxylase deficiency (11BOHD) in Turkish population and novel mutations in CYP11B1 gene |journal=J. Steroid Biochem. Mol. Biol. |volume= |issue= |pages= |date=April 2018 |pmid=29626607 |doi=10.1016/j.jsbmb.2018.04.001 |url=}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! align="center" style="background:#DCDCDC;" + |[[17 alpha-hydroxylase deficiency|17α−Hydroxylase deficiency]]<ref name="GoldsmithSolomon1967">{{cite journal|last1=Goldsmith|first1=Oliver|last2=Solomon|first2=David H.|last3=Horton|first3=Richard|title=Hypogonadism and Mineralocorticoid Excess|journal=New England Journal of Medicine|volume=277|issue=13|year=1967|pages=673–677|issn=0028-4793|doi=10.1056/NEJM196709282771302}}</ref> | ! align="center" style="background:#DCDCDC;" + |[[17 alpha-hydroxylase deficiency|17α−Hydroxylase deficiency]]<ref name="GoldsmithSolomon1967">{{cite journal|last1=Goldsmith|first1=Oliver|last2=Solomon|first2=David H.|last3=Horton|first3=Richard|title=Hypogonadism and Mineralocorticoid Excess|journal=New England Journal of Medicine|volume=277|issue=13|year=1967|pages=673–677|issn=0028-4793|doi=10.1056/NEJM196709282771302}}</ref> | ||
| align="center" style="background:#F5F5F5;" + | − | | align="center" style="background:#F5F5F5;" + | − | ||
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! align="center" style="background:#4479BA; color: #FFFFFF;" + |Systemic | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Systemic | ||
! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cystic fibrosis]]<ref name="pmid9048354">{{cite journal |vauthors=Bates CM, Baum M, Quigley R |title=Cystic fibrosis presenting with hypokalemia and metabolic alkalosis in a previously healthy adolescent |journal=J. Am. Soc. Nephrol. |volume=8 |issue=2 |pages=352–5 |date=February 1997 |pmid=9048354 |doi= |url=}}</ref> | ! colspan="2" align="center" style="background:#DCDCDC;" + |[[Cystic fibrosis]]<ref name="pmid9048354">{{cite journal |vauthors=Bates CM, Baum M, Quigley R |title=Cystic fibrosis presenting with hypokalemia and metabolic alkalosis in a previously healthy adolescent |journal=J. Am. Soc. Nephrol. |volume=8 |issue=2 |pages=352–5 |date=February 1997 |pmid=9048354 |doi= |url=}}</ref> | ||
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! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Category | ||
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | ! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Fever | ||
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dyspnea | ||
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! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Other findings | ||
|} | |} | ||
==References == | ==References == | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 08:54, 13 October 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Alkalosis refers to a condition reducing hydrogen ion concentration of arterial blood plasma (alkalemia) through the loss of acids or retention of bicarbonate. Generally alkalosis is said to occur when pH of the blood exceeds 7.45. The opposite condition is acidosis.
Classification
More specifically, alkalosis can refer to:
Causes
Common Causes
The main cause of respiratory alkalosis is hyperventilation, resulting in a loss of carbon dioxide. Compensatory mechanisms for this would include increased dissociation of the carbonic acid buffering intermediate into hydrogen ions, and the related consumption of bicarbonate, both of which would lower blood pH.
Metabolic alkalosis can be caused by prolonged vomitting, resulting in a loss of hydrochloric acid with the stomach content. Severe dehydration, and the consumption of alkali are other causes. Compensatory mechanism for metabolic alkalosis involve slowed breathing by the lungs to increase serum carbon dioxide, a condition leaning toward respiratory acidosis. As respiratory acidosis often accompanies the compensation for metabolic alkalosis, and visa versa, a delicate balance is created between these two conditions.
Causes in Alphabetical Order
Metabolic Alkalosis
- Administration of citrates
- After respiratory acidosis
- Alkali therapy for stomach problems
- Bartter's Syndrome
- Conn syndrome
- Cushing's Syndrome
- Cystic Fibrosis
- Diarrhea
- Gastric juice drainage
- Hepatic coma
- Hyperemesis gravidarum
- Milk Alkali Syndrome
- Mineralcorticoid therapy
- Overcorrection of acidosis with bicarbonates
- Renal potassium loss
- Vomiting
Pathophysiology
Metabolic Alkalosis
It is thought that metabolic [alkalosis] is the result of the shift of hydrogen ions intracellularly, reduced blood volume, loss of gastric acid, and extracellular volume expansion.
Shift of hydrogen ions intracellularly
- Electrolyte imbalance like hypokalemia causes a shift of hydrogen ions intracellular caused defect of protons and an increase in bicarbonate ion concentration. [1]
Reduced Blood volume
- Volume depletion results in reduced glomerular filtration rate. This stimulates the production of Angiotensin II, sympathetic nervous system activation, and aldosterone secretion.
- The sympathetic nervous system and angiotensin II causes increased absorption of sodium in proximal convoluted tubules via sodium hydrogen exchange.
- Aldosterone acts primarily on the principal cells of the late distal convoluted tubule and collecting ducts. It causes sodium and water retention in exchange for potassium and hydrogen ions secretion. The loop and thiazide diuretics also act by similar mechanisms of action.[2]
Loss of Gastric acid
- The hydrogen ions are primarily secreted in large amounts in the gastric juice. The hydrogen ions are secreted via active transport mediated by hydrogen potassium ATPase pump. Excessive vomiting causes loss of a large amount of gastric juice with depletion of hydrogen and chloride from the body.
Extracellular volume expansion
- Primary hyperaldosteronism (Conn’s syndrome) causes increased sodium reabsorption with the resultant increase in extracellular volume. The patient may be hypertensive or normotensive. The hypokalemia caused by the action of aldosterone causes increased reabsorption of sodium bicarbonate in the proximal convoluted tubule with a worsening of metabolic alkalosis.
Respiratory Alkalosis
- It is thought that the respiratory alkalosis is the result of hyperventilation. The causes of hyperventilation can be due to increased stimulation of the medullary respiratory center, low oxygen tension in blood, lung pathologies, and iatrogenic. The stimulation of the respiratory center occurs due to stroke, head injury, metabolic disease like hyperthyroidism, emotional stress, panic attack, and side effect of medications like aspirin. The low oxygen tension in the blood causes stimulation of the respiratory center resulting in hyperventilation and hypocapnia. The acute attack of asthma, COPD, pulmonary embolism can cause tachypnea with increase loss of carbon dioxide.
Epidemiology and Demographics
- The prevalence of alkalosis ranges from 32,727 to 80,000 per 100,000 in hospitalized patients with an acid-base metabolic disorder. [3][4]
- The prevalence of alkalosis is approximately 44,046 per 100,000 in acute heart failure patients. [5]
Differential Diagnosis
Differential diagnosis of metabolic alkalosis is as follow:
| Category | Disease | Clinical | Paraclinical | Gold standard diagnosis | Other findings | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Signs | Lab data | ||||||||||||||||||||||||
| ABG | Chemistry | Enzyme | Renal function | |||||||||||||||||||||||
| Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | |||||||||
| Exogenous HCO3− loads | Acute alkali administration[6] | − | + | − | + | ↓ | − | ↑ | ↑ | ↓ | ↓ | ↓ | ↓ | ↑ | Nl | Nl | ↑ | ↑ | Nl | Clinical manifestations |
| |||||
| Milk−alkali syndrome[7] | − | + | − | + | ↓ | + | ↑ | ↑ | ↓ | ↓ | ↓ | ↓ | ↑ | ↓ | ↑ | ↑ | ↑ | Nl | Clinical manifestationsk + exclusion of other causes of hypercalcemia |
| ||||||
| Transfusion[8] | ± | ± | − | + | ↓ | − | ↑ | ↑ | ↓ | ↓ | ↓/↑ | ↓ | ↓ | ↑ | ↑ | Nl to ↑ | Nl to ↑ | Nl | History of administration of large quantities of blood products that contain sodium citrate |
| ||||||
| Drugs/Medication | Chloruretic diuretics[9] | + | − | + | + | − | − | − | − | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl to ↑ | ↑ | History of diuretic use | ||
| Penicillin[10] | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↓ | ↑ | Nl | Nl | Nl | History of penicillin use |
| ||||||
| Licorice[11][12] | − | − | − | + | Nl to ↑ | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl to ↑ | Nl | Clinical manifestations | |||||||
| Laxative abuse[13] | − | − | ± | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↑ | ↑ | Nl to ↑ | Nl | ↓ | High level of suspicion |
| ||||||
| Antacids[14][15] |
|
− | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↑ | Nl | Nl to ↑ | Nl to ↑ | Nl | Clinical manifestations |
| |||||
| Category | Disease | Hydrogen loss | Accumulation of base | Chloride depletion | Mineralocorticoid excess | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | Gold standard diagnosis | Other findings | |
| Gastrointestinal origin | Vomiting[16] | ± | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Clinical manifestations |
| |||||
| Nasogastric tube suction[17] | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Clinical manifestations | |||||||
| Zollinger−Ellison syndrome[18] | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Serum gastrin concentration + secretin stimulation test |
| ||||||
| Bulimia nervosa[19] | − | − | ± | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | Nl | ↓ | ↑ | Nl to ↑ | Nl | ↓ | High level of suspicion |
| ||||||
| Congenital chloridorrhea[20] | − | − | ± | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↓ | ↓ | ↑ | Nl to ↑ | Nl to ↑ | Nl to ↑ | Clinical manifestations+ lab findings |
| ||||||
| Pyloric stenosis[21] | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ ↑ | Nl | Nl | ↑ | Nl to ↑ | Nl | ↓ | Physical exam + imaging |
| ||||||
| Villous adenoma[22] | − | − | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↓ | ↓ | ↑ | Nl to ↑ | Nl | ↑ | Colonoscopy | |||||||
| Gastrocystoplasty[23] | − | − | + | − | ↓ | − | ↑ | ↑ | Nl | ↓ | Nl | Nl | Nl | Nl | Nl | Nl to ↑ | Nl to ↑ | Nl | History of operation | |||||||
| Category | Disease | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | Gold standard diagnosis | Other findings | |||||
| Renal origin | Posthypercapnic state[24] | − | ± | − | − | Nl | − | ↑ | ↑↑ | ↓ | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab findings |
| |||||
| Hypomagnesemia[25] | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab findings |
| ||||||
| Hypokalemia[26] | − | − | − | − | Nl | − | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | Nl | ↑ | Nl | Nl | Nl | Lab findings |
| ||||||
| Bartter's syndrome[27] | − | − | − | − | Nl | + | ↑ | ↑ | Nl | ↓ | ↓↓ | ↓ | ↓ | Nl | ↑ | Nl to ↑ | Nl to ↑ | Nl | Genetic testing | |||||||
| Gitelman’s syndrome[28][29] | − | − | − | − | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓↓ | ↓ | Nl | ↓ | ↑ | Nl | Nl | Nl | Genetic testing |
| ||||||
| Renal artery stenosis[30] | − | + | + | + | ↑ | + | ↑ | ↑ | ↓ | ↓ | ↑ | ↓ | ↑ | Nl | ↑ | ↑ | ↑ | Nl | Clinical manifestations+ imaging |
| ||||||
| Liddle syndrome[31] | − | − | − | − | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓↓ | ↓ | Nl | ↓ | ↑ | Nl | Nl | Nl | Genetic testing |
| ||||||
| Renal tumors[32] | − | + | + | + | ↑ | + | ↑ | ↑ | ↓ | ↓ | ↑ | ↓ | ↑ | Nl | ↑ | ↑ | ↑ | Nl | Biopsy |
| ||||||
| Endocrine | Cushing's syndrome[33] | − | − | + | − | ↑ | + | ↑ | ↑ | Nl | ↓ | ↑ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | Nl | 24−hour urinary cortisol excretion + low−dose dexamethasone suppression test | ||||||
| Hyperaldosteronism | Primary[34] | − | − | + | − | ↑ | + | ↑ | ↑ | Nl | ↓ | Nl to ↓ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | Nl | Lab findings |
| |||||
| Secondary[35] | − | + | + | + | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↑ | Nl | ↓ | ↑ | ↑ | ↑ | Nl | Lab findings |
| ||||||
| Congenital adrenal hyperplasia | 11β−Hydroxylase deficiency[36] | − | − | + | − | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↑ | Nl | ↓ | Nl | Nl | Nl | Genetic testing |
| |||||
| 17α−Hydroxylase deficiency[37] | − | − | + | − | ↑ | + | ↑ | ↑ | Nl | ↓ | ↓ | ↓ | ↑ | Nl | ↓ | Nl | Nl | Nl | Genetic testing |
| ||||||
| Systemic | Cystic fibrosis[38] | − | + | − | + | ↓ | + | ↑ | ↑ | Nl | ↓ | ↓ | Nl | Nl | Nl | ↑ | Nl to ↑ | Nl | ↑ | Genetic testing |
| |||||
| Category | Disease | Fever | Dyspnea | Edema | Toxic/ill | BP | Dehydration | HCO3− | paCO2 | O2 | Cl− | K+ | Na+ | Ca+ | Mg+ | Renin | Bun | Cr | Urine Cl− | Gold standard diagnosis | Other findings | |||||
References
- ↑ Halperin ML, Scheich A (1994). "Should we continue to recommend that a deficit of KCl be treated with NaCl? A fresh look at chloride-depletion metabolic alkalosis". Nephron. 67 (3): 263–9. doi:10.1159/000187977. PMID 7936014.
- ↑ Hamm LL, Nakhoul N, Hering-Smith KS (2015). "Acid-Base Homeostasis". Clin J Am Soc Nephrol. 10 (12): 2232–42. doi:10.2215/CJN.07400715. PMC 4670772. PMID 26597304.
- ↑ Palange P, Carlone S, Galassetti P, Felli A, Serra P (1990). "Incidence of acid-base and electrolyte disturbances in a general hospital: a study of 110 consecutive admissions". Recenti Prog Med. 81 (12): 788–91. PMID 2075281.
- ↑ Hodgkin JE, Soeprono FF, Chan DM (1980). "Incidence of metabolic alkalemia in hospitalized patients". Crit Care Med. 8 (12): 725–8. doi:10.1097/00003246-198012000-00005. PMID 6778655.
- ↑ Park JJ, Choi DJ, Yoon CH, Oh IY, Lee JH, Ahn S; et al. (2015). "The prognostic value of arterial blood gas analysis in high-risk acute heart failure patients: an analysis of the Korean Heart Failure (KorHF) registry". Eur J Heart Fail. 17 (6): 601–11. doi:10.1002/ejhf.276. PMID 26096207.
- ↑ Máttar, João A.; Weil, Max Harry; Shubin, Herbert; Stein, Leon (1974). "Cardiac arrest in the critically III". The American Journal of Medicine. 56 (2): 162–168. doi:10.1016/0002-9343(74)90593-2. ISSN 0002-9343.
- ↑ Abreo, Kenneth (1993). "The Milk-Alkali Syndrome". Archives of Internal Medicine. 153 (8): 1005. doi:10.1001/archinte.1993.00410080065011. ISSN 0003-9926.
- ↑ Gupta M, Wadhwa NK, Bukovsky R (January 2004). "Regional citrate anticoagulation for continuous venovenous hemodiafiltration using calcium-containing dialysate". Am. J. Kidney Dis. 43 (1): 67–73. PMID 14712429.
- ↑ Luke, R. G.; Galla, J. H. (2012). "It Is Chloride Depletion Alkalosis, Not Contraction Alkalosis". Journal of the American Society of Nephrology. 23 (2): 204–207. doi:10.1681/ASN.2011070720. ISSN 1046-6673.
- ↑ Zaki, SyedAhmed; Lad, Vijay (2011). "Piperacillin-tazobactam-induced hypokalemia and metabolic alkalosis". Indian Journal of Pharmacology. 43 (5): 609. doi:10.4103/0253-7613.84986. ISSN 0253-7613.
- ↑ Meltem, Akkas Camkurt; Figen, Coskun; Nalan, Metin Aksu; Mahir, Kunt; Sebnem, Bozkurt; Mehlika, Isildak; Kasim, Kilic Ahmet; Miyase, Bayraktar (2009). "A hypokalemic muscular weakness after licorice ingestion: a case report". Cases Journal. 2 (1): 8053. doi:10.4076/1757-1626-2-8053. ISSN 1757-1626.
- ↑ Lin, Shih-Hua; Yang, Sung-Sen; Chau, Tom; Halperin, Mitchell L. (2003). "An Unusual Cause of Hypokalemic Paralysis: Chronic Licorice Ingestion". The American Journal of the Medical Sciences. 325 (3): 153–156. doi:10.1097/00000441-200303000-00008. ISSN 0002-9629.
- ↑ Roerig, James L.; Steffen, Kristine J.; Mitchell, James E.; Zunker, Christie (2010). "Laxative Abuse". Drugs. 70 (12): 1487–1503. doi:10.2165/11898640-000000000-00000. ISSN 0012-6667.
- ↑ Sahani, Mandeep M.; Brennan, John F.; Nwakanma, Chukwuemeka; Chow, May T.; Ing, Todd S.; Leehey, David J. (2001). "Metabolic Alkalosis in a Hemodialysis Patient After Ingestion of a Large Amount of an Antacid Medication". Artificial Organs. 25 (4): 313–315. doi:10.1046/j.1525-1594.2001.06714.x. ISSN 0160-564X.
- ↑ Vanpee, Dominique; Delgrange, Etienne; Gillet, Jean-Bernard; Donckier, Julian (2000). "Ingestion of antacid tablets (Rennie®) and acute confusion". The Journal of Emergency Medicine. 19 (2): 169–171. doi:10.1016/S0736-4679(00)00206-7. ISSN 0736-4679.
- ↑ Gan, Tong J.; Meyer, Tricia; Apfel, Christian C.; Chung, Frances; Davis, Peter J.; Eubanks, Steve; Kovac, Anthony; Philip, Beverly K.; Sessler, Daniel I.; Temo, James; Tram??r, Martin R.; Watcha, Mehernoor (2003). "Consensus Guidelines for Managing Postoperative Nausea and Vomiting". Anesthesia & Analgesia: 62–71. doi:10.1213/01.ANE.0000068580.00245.95. ISSN 0003-2999.
- ↑ Gilbertson, Heather Ruth; Rogers, Elizabeth Jessie; Ukoumunne, Obioha Chukwunyere (2011). "Determination of a Practical pH Cutoff Level for Reliable Confirmation of Nasogastric Tube Placement". Journal of Parenteral and Enteral Nutrition. 35 (4): 540–544. doi:10.1177/0148607110383285. ISSN 0148-6071.
- ↑ Hung, Patrick D.; Schubert, Mitchell L.; Mihas, Anastasios A. (2003). "Zollinger-Ellison syndrome". Current Treatment Options in Gastroenterology. 6 (2): 163–170. doi:10.1007/s11938-003-0017-6. ISSN 1092-8472.
- ↑ Shapiro, Jennifer R.; Berkman, Nancy D.; Brownley, Kimberly A.; Sedway, Jan A.; Lohr, Kathleen N.; Bulik, Cynthia M. (2007). "Bulimia nervosa treatment: A systematic review of randomized controlled trials". International Journal of Eating Disorders. 40 (4): 321–336. doi:10.1002/eat.20372. ISSN 0276-3478.
- ↑ Wedenoja, S.; HãGlund, P.; Holmberg, C. (2010). "Review article: the clinical management of congenital chloride diarrhoea". Alimentary Pharmacology & Therapeutics. 31 (4): 477–485. doi:10.1111/j.1365-2036.2009.04197.x. ISSN 0269-2813. C1 control character in
|last2=at position 3 (help) - ↑ Bakal, Unal; Sarac, Mehmet; Aydin, Mustafa; Tartar, Tugay; Kazez, Ahmet (2016). "Recent changes in the features of hypertrophic pyloric stenosis". Pediatrics International. 58 (5): 369–371. doi:10.1111/ped.12860. ISSN 1328-8067.
- ↑ Gennari, F. J.; Weise, W. J. (2008). "Acid-Base Disturbances in Gastrointestinal Disease". Clinical Journal of the American Society of Nephrology. 3 (6): 1861–1868. doi:10.2215/CJN.02450508. ISSN 1555-9041.
- ↑ Kurzrock, Eric A.; Baskin, Laurence S.; Kogan, Barry A. (1998). "GASTROCYSTOPLASTY: LONG-TERM FOLLOWUP". The Journal of Urology. 160 (6): 2182–2186. doi:10.1016/S0022-5347(01)62289-4. ISSN 0022-5347.
- ↑ Banga, Amit; Khilnani, G. C. (2009). "Post-hypercapnic Alkalosis is Associated with Ventilator Dependence and Increased ICU stay". COPD: Journal of Chronic Obstructive Pulmonary Disease. 6 (6): 437–440. doi:10.3109/15412550903341448. ISSN 1541-2555.
- ↑ Elisaf M, Milionis H, Siamopoulos KC (1997). "Hypomagnesemic hypokalemia and hypocalcemia: clinical and laboratory characteristics". Miner Electrolyte Metab. 23 (2): 105–12. PMID 9252977.
- ↑ Galla JH (February 2000). "Metabolic alkalosis". J. Am. Soc. Nephrol. 11 (2): 369–75. PMID 10665945.
- ↑ Simon, David B.; Karet, Fiona E.; Hamdan, Jahed M.; Pietro, Antonio Di; Sanjad, Sami A.; Lifton, Richard P. (1996). "Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na–K–2CI cotransporter NKCC2". Nature Genetics. 13 (2): 183–188. doi:10.1038/ng0696-183. ISSN 1061-4036.
- ↑ Fremont, Oliver T.; Chan, James C. M. (2012). "Understanding Bartter syndrome and Gitelman syndrome". World Journal of Pediatrics. 8 (1): 25–30. doi:10.1007/s12519-012-0333-9. ISSN 1708-8569.
- ↑ Colussi G, Macaluso M, Brunati C, Minetti L (1994). "Calcium metabolism and calciotropic hormone levels in Gitelman's syndrome". Miner Electrolyte Metab. 20 (5): 294–301. PMID 7700218.
- ↑ Safian, Robert D.; Textor, Stephen C. (2001). "Renal-Artery Stenosis". New England Journal of Medicine. 344 (6): 431–442. doi:10.1056/NEJM200102083440607. ISSN 0028-4793.
- ↑ Salih, Mahdi; Gautschi, Ivan; van Bemmelen, Miguel X.; Di Benedetto, Michael; Brooks, Alice S.; Lugtenberg, Dorien; Schild, Laurent; Hoorn, Ewout J. (2017). "A Missense Mutation in the Extracellular Domain ofαENaC Causes Liddle Syndrome". Journal of the American Society of Nephrology. 28 (11): 3291–3299. doi:10.1681/ASN.2016111163. ISSN 1046-6673.
- ↑ Lasseigne, Brittany N.; Brooks, James D. (2018). "The Role of DNA Methylation in Renal Cell Carcinoma". Molecular Diagnosis & Therapy. doi:10.1007/s40291-018-0337-9. ISSN 1177-1062.
- ↑ Araujo Castro, Marta; Marazuela Azpiroz, Mónica (2018). "Two types of ectopic Cushing syndrome or a continuum? Review". Pituitary. doi:10.1007/s11102-018-0894-2. ISSN 1386-341X.
- ↑ Martell-Claros, Nieves; Abad-Cardiel, María; Alvarez-Alvarez, Beatriz; García-Donaire, José A.; Pérez, Cristina Fernández (2015). "Primary aldosteronism and its various clinical scenarios". Journal of Hypertension. 33 (6): 1226–1232. doi:10.1097/HJH.0000000000000546. ISSN 0263-6352.
- ↑ Monticone S, Losano I, Tetti M, Buffolo F, Veglio F, Mulatero P (May 2018). "Diagnostic approach to low renin hypertension". Clin. Endocrinol. (Oxf). doi:10.1111/cen.13741. PMID 29758100.
- ↑ Baş F, Toksoy G, Ergun-Longmire B, Uyguner ZO, Abalı ZY, Poyrazoğlu Ş, Karaman V, Avcı Ş, Altunoğlu U, Bundak R, Karaman B, Başaran S, Darendeliler F (April 2018). "Prevalence, clinical characteristics and long-term outcomes of classical 11 β-hydroxylase deficiency (11BOHD) in Turkish population and novel mutations in CYP11B1 gene". J. Steroid Biochem. Mol. Biol. doi:10.1016/j.jsbmb.2018.04.001. PMID 29626607.
- ↑ Goldsmith, Oliver; Solomon, David H.; Horton, Richard (1967). "Hypogonadism and Mineralocorticoid Excess". New England Journal of Medicine. 277 (13): 673–677. doi:10.1056/NEJM196709282771302. ISSN 0028-4793.
- ↑ Bates CM, Baum M, Quigley R (February 1997). "Cystic fibrosis presenting with hypokalemia and metabolic alkalosis in a previously healthy adolescent". J. Am. Soc. Nephrol. 8 (2): 352–5. PMID 9048354.