Causes and Clinical Features of Metabolic Alkalosis

Overview of Metabolic Alkalosis

Metabolic alkalosis is a disturbance in acid-base balance characterized by an elevated pH due to excessive loss of acid or an increase in bicarbonate levels in the blood.

Causes of Metabolic Alkalosis

• Loss of gastric acid - Chronic vomiting or nasogastric suctioning removes hydrochloric acid from the stomach, leading to an increase in pH.
• Renal disorders - Conditions such as Bartter syndrome or Gitelman syndrome cause excessive loss of chloride and potassium, promoting alkalosis.
• Diuretics - Use of loop or thiazide diuretics results in increased bicarbonate reabsorption and acid loss.
• Excessive alkali intake - Overconsumption of bicarbonate-containing substances, such as antacids or milk-alkali syndrome, leads to metabolic alkalosis.

Clinical Features

• Neuromuscular symptoms - Symptoms like muscle twitching, tetany, and cramps due to calcium ion alterations.
• Cardiovascular manifestations - Hypokalemia-related arrhythmias or reduced myocardial contractility.
• Neurological symptoms - Confusion, dizziness, and irritability due to altered cerebral function.

Diagnosis and Treatment

Blood gas analysis and electrolyte assessments confirm metabolic alkalosis. Treatment aims at addressing the underlying cause, such as replenishing chloride and potassium, discontinuing diuretics, or managing underlying renal disorders.