Template:Metabolic alkalosis DDX

Metabolic alkalosis

• Chloride-responsive (urine Cl <25 mEq/L)
  • Vomiting
  • Nasogastric suction
  • Diuretics (thiazide, loop) — after discontinuation
  • Post-hypercapnic alkalosis
  • Cystic fibrosis (sweat losses)
  • Villous adenoma (rare)
• Chloride-resistant (urine Cl >40 mEq/L)
  • Hyperaldosteronism (primary)
  • Cushing syndrome
  • Bartter syndrome
  • Gitelman syndrome
  • Liddle syndrome
  • Severe hypokalemia
  • Exogenous mineralocorticoid/licorice ingestion
  • Renal artery stenosis
• Alkali administration
  • Bicarbonate administration
  • Citrate (massive transfusion)
  • Milk-alkali syndrome
  • Antacid overuse
• Other
  • Contraction alkalosis (dehydration)
  • Refeeding alkalosis
  • Diuretics (active use)