endocrine and metabolic disorders
Metabolic Alkalosis
Diagnosis of Metabolic Alkalosis
Arterial blood gas (ABG) and serum electrolyte measurements Diagnosis of cause (usually clinical) Sometimes measurement of urinary Cl−and K+ Recognition of metabolic alkalosis and appropriate respiratory compensation is discussed in Diagnosis and requires measurement of ABG and serum electrolytes (including Ca and Mg). concentrations are measured (values are not diagnostic in Stages of chronic kidney disease ). reabsorption and hence a Cl-responsive cause (see table Causes of Metabolic Alkalosis ) Urinary Cl > 20 mEq/L (> 20 mmol/L) suggests a chloride-unresponsive form. Urinary K and the presence or absence of Hypertension help differentiate the chloride-unresponsive alkaloses. 30 mEq/day (< 30 mmol/day) signifies Hypokalemia or laxative misuse. 30 mEq/day (> 30 mmol/day) in a patient without hypertension suggests diuretic abuse or Bartter Syndrome and Gitelman Syndrome or 30 mEq/day (> 30 mmol/day) in a patient with Hypertension requires evaluation for hyperaldosteronism, mineralocorticoid excess, and renovascular disease. Tests in patients with hypertension typically include plasma renin activity and aldosterone and cortisol levels (see Diagnosis and 