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20-September-2008 09:55:49 - alkalosis Metabolic alkalosis Classification and external resources Davenport diagram ICD-10 E87.3 ICD-9 276.3 DiseasesDB 402 eMedicine med/1459 Metabolic alkalosis is a metabolic condition in which the pH of the blood is elevated beyond the normal range. This is usually the result of decreased hydrogen ion concentration, leading to increased bicarbonate, or alternatively a direct result of increased bicarbonate concentrations. Contents 1 Causes 2 Compensation 3 See also 4 References Causes There are five main causes of metabolic alkalosis1: 1. Loss of hydrogen ions - Most often occurs via two mechanisms, either vomiting or renally. Vomiting results in the loss of hydrochloric acid with the stomach content, which consumes hydrogen ions, raising the pH of the blood. Renal losses of hydrogen ions occurs when excess aldosterone induces the retention of sodium and hence the excretion of hydrogen. 2. Retention of bicarbonate - As a compensatory mechanism for respiratory acidosis, the kidneys will increase their retention of bicarbonate in order to raise blood pH. Prolonged respiratory acidosis may cause the retention of bicarbonate. If respiratory acidosis is prolonged, due to impaired pulmonary function, the resulting excess of bicarbonate can then raise blood pH too high, which compensates respiratory acidosis. 3. Shift of hydrogen ions into intracellular space - Seen in hypokalemia. Due to a low extracellular potassium concentration, potassium shifts out of the cells. In order to maintain electrical neutrality, hydrogen shifts into the cells, raising blood pH. 4. Alkalotic agents - Alkalotic agents, such as bicarbonate or antacids, administered in excess can lead to an alkalosis. 5. Contraction alkalosis - This results from a loss of water in the extracellular space which is poor in bicarbonate, typically from diuretic use. Since water is lost while bicarbonate is retained, the concentration of bicarbonate increases blood pH. See also loop diuretics and hyperaldosteronism. Compensation Compensation for metabolic alkalosis occurs mainly in the lungs, which retain carbon dioxide CO2 through slower breathing, or hypoventilation respiratory compensation. CO2 is then consumed toward the formation of the carbonic acid intermediate, thus decreasing pH. Renal compensation for metabolic alkalosis, less effective than respiratory compensation, consists of increased excretion of HCO3- bicarbonate, as the filtered load of HCO3- exceeds the ability of the renal tubule to reabsorb it. See also hypokalemia References ^ eMedicine - Metabolic Alkalosis : Article by Sameer Yaseen v d e Water-electrolyte imbalance and acid-base imbalance E86-E87, 276 Volume status Dehydration/Hypervolemia - Hypovolemia Electrolyte Na+ Hypernatremia/Hyponatremia K+ Hyperkalemia/Hypokalemia Cl- Hyperchloremia/Hypochloremia Acid-base Acidosis: Metabolic - Respiratory - Lactic - Ketosis Alkalosis: Metabolic, Respiratory Mixed disorder of acid-base balance This disease article is a stub. Retrieved from http://en..org/wiki/Metabolic_alkalosis Categories: Metabolic disorders | Electrolyte disturbances | Disease stubs Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Deutsch Italiano This page was last modified on 17 July 2008, at 21:05
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