Metabolic Alkalosis

Overview


Plain-Language Overview

Metabolic alkalosis is a condition where the body's blood becomes too alkaline, meaning it has a higher pH than normal. This happens when there is an excess of bicarbonate or a loss of acid in the body, affecting the body's acid-base balance. The main body system involved is the respiratory and renal systems, which work together to regulate blood pH. When metabolic alkalosis occurs, it can cause symptoms like muscle twitching, irritability, and confusion due to changes in how cells function. It often results from vomiting, dehydration, or certain medications that affect kidney function. The condition impacts overall health by disrupting normal cellular activities and can lead to serious complications if untreated. Understanding this imbalance helps guide appropriate medical care.

Clinical Definition

Metabolic alkalosis is defined as a primary increase in serum bicarbonate concentration leading to an elevated blood pH above 7.45. It results from either a net gain of bicarbonate or a loss of hydrogen ions, commonly caused by prolonged vomiting, diuretic use, or mineralocorticoid excess. The condition is characterized by a compensatory hypoventilation response to retain carbon dioxide and partially correct pH. It is clinically significant because it can cause hypokalemia, hypocalcemia, and decreased tissue oxygen delivery due to leftward shift of the oxygen-hemoglobin dissociation curve. Diagnosis requires distinguishing between chloride-responsive and chloride-resistant forms based on urinary chloride levels. Understanding the underlying mechanism is crucial for targeted treatment and preventing complications such as cardiac arrhythmias and neuromuscular irritability.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


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