Evaluation of metabolic alkalosis

Last reviewed: 4 Apr 2025
Last updated: 03 Jan 2025

Summary

Differentials

Common

  • Current diuretic therapy
  • Gastric secretion losses
  • Postdiuretic therapy
  • Posthypercapnia
  • Bicarbonate administration
  • Milk-alkali syndrome
Full details

Uncommon

  • Primary hyperaldosteronism
  • Secondary hyperaldosteronism
  • Renal artery stenosis
  • Cushing syndrome
  • Licorice ingestion
  • Tobacco chewing
  • Apparent mineralocorticoid excess
  • Liddle syndrome
  • Bartter syndrome
  • Gitelman syndrome
  • Profound potassium depletion
  • Hypercalcemia of nonhyperparathyroid etiology
  • Poststarvation refeeding syndrome
  • Transfusion of blood products (sodium citrate)
  • Villous adenoma
  • Congenital chloride diarrhea
  • Cystic fibrosis
Full details

Contributors

Authors

Dinkar Kaw, MD, FACP, FASN
Dinkar Kaw

Professor of Medicine

Division of Nephrology

Department of Medicine

University of Toledo College of Medicine and Life Sciences

Toledo

OH

Disclosures

DK declares that he has no competing interests.

Acknowledgements

Dr Dinkar Kaw would like to gratefully acknowledge Dr Joseph I. Shapiro, a previous contributor to this topic.

Disclosures

JIS declared that he had no competing interests.

Peer reviewers

Chris Abbiss, BSc

School of Exercise

Biomedical and Health Science

Edith Cowan University

Western Australia

Disclosures

CA declares that he has no competing interests.

Mark Cowan, MD, FCCP

Assistant Professor of Medicine

Division of Pulmonary and Critical Care Medicine

The University of Maryland

Chief of Pulmonary and Critical Care Medicine

MICU Director

Baltimore VA Medical Center

Baltimore

MD

Disclosures

MC declares that he has no competing interests.

References

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Key articles

Galla JH. Metabolic alkalosis. J Am Soc Nephrol. 2000 Feb;11(2):369-75.Full text  Abstract

Khanna A, Kurtzman NA. Metabolic alkalosis. J Nephrol. 2006 Mar-Apr;19(Suppl 9):S86-96. Abstract

Royal College of Pathologists of Australasia. Alkalosis. 2014 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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