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**Basic metabolic panel showing electrolytes imbalance.
**Basic metabolic panel showing electrolytes imbalance.
**Serum renin and aldosterone:  
**Serum renin and aldosterone:  
***High Renin, High aldosterone:• Malignant hypertension renovascular hypertension • Renin secretin tumor
***Elevated Renin, Elevated aldosterone:• Hypertensive emergency or urgency or Malignant HTN Renal HTN • Renin secretin tumor
***Low Renin, High aldosterone:• Aldosterone secreting tumor Adrenal hyperplasia Glucocorticoid remediable aldosteronism
***Reduced Renin, Elevated aldosterone:• Aldosterone producing cancer CAH Hyperaldosteronism treated with glucocorticoids
***Low Renin, Low Aldosterone:• Licorice • Liddle's syndrome • Enzyme deficiency
***Reduced Renin, Reduced Aldosterone:• Liddle's syndrome • Congenital Enzyme deficiency • Consumption of Licorice
**Urine analysis with Urine pH and Urine chloride and sodium: low urine Cl(• Gastric: Vomiting, NG suction • Lower bowel: Villous adenoma, chloridorrhea, laxative abuse), high urine Cl (• Non-reabsorbed ions: Penicillin • Impaired tubular transport: Loop and thiazide diuretics, Bartter's and Gitelman's disease, Hypomagnesaemia)
**Urine analysis with Urine pH and Urine chloride and sodium: low urine chloride(• GI loss: Emesis, Nasogastric tube suction • Lower Gastrointestinal etiology: Villous adenoma, chloridorrhea, excessive purgative use), high urine Cl (• Penicillin • Dysfunctional tubular transport: Loop Diuretics and thiazide diuretics, Bartter's and Gitelman's disease, Hypomagnesaemia)


*Some patients with Metabolic alkalosis may have severely reduced GFR with azotemia, which is usually suggestive of renal failure.
*Some patients with Metabolic alkalosis may have severely reduced GFR with azotemia, which is usually suggestive of renal failure.

Revision as of 05:24, 25 February 2021

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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]

Overview

Laboratory findings consistent with the diagnosis of Metabolic Alkalosis include ABG (Blood pH is elevated more than 7.45, Serum Bicarbonate level is elevate more than 26 mole Equilibrium/Liter, Partial pressure of CO2 reduces to combat elevated bicarbonate), high or low Serum aldosterone/Serum renin, and Urine analysis with Urine pH and high or low Urine chloride and sodium.


Laboratory Findings

  • Laboratory findings consistent with the diagnosis of Metabolic Alkalosis
    • ABG (Blood pH is elevated more than 7.45, Serum Bicarbonate level is elevate more than 26 mole Equilibrium/Liter, Partial pressure of CO2 reduces to combat elevated bicarbonate)
    • Basic metabolic panel showing electrolytes imbalance.
    • Serum renin and aldosterone:
      • Elevated Renin, Elevated aldosterone:• Hypertensive emergency or urgency or Malignant HTN • Renal HTN • Renin secretin tumor
      • Reduced Renin, Elevated aldosterone:• Aldosterone producing cancer • CAH • Hyperaldosteronism treated with glucocorticoids
      • Reduced Renin, Reduced Aldosterone:• Liddle's syndrome • Congenital Enzyme deficiency • Consumption of Licorice
    • Urine analysis with Urine pH and Urine chloride and sodium: low urine chloride(• GI loss: Emesis, Nasogastric tube suction • Lower Gastrointestinal etiology: Villous adenoma, chloridorrhea, excessive purgative use), high urine Cl (• Penicillin • Dysfunctional tubular transport: Loop Diuretics and thiazide diuretics, Bartter's and Gitelman's disease, Hypomagnesaemia)
  • Some patients with Metabolic alkalosis may have severely reduced GFR with azotemia, which is usually suggestive of renal failure.

References

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