Gastrointestinal hydrogen loss |
Vomiting or nasogastric suction |
Congenital chloride diarrhea (congenital chloridorrhea) |
Renal hydrogen loss |
Primary mineralocorticoid excess (primary hyperaldosteronism, Cushing syndrome [usually associated with ectopic ACTH] exogenous mineralocorticoids) |
Mineralocorticoid excess-like states - Licorice ingestion
- Liddle syndrome
- Apparent mineralocorticoid excess
|
Loop or thiazide diuretics |
Bartter or Gitelman syndrome |
Status post chronic hypercarbia |
Severe hypokalemia causing both intracellular hydrogen shift and renal hydrogen excretion |
Villous adenoma (may manifest metabolic alkalosis, metabolic acidosis, or both) |
Laxative abuse (may manifest metabolic alkalosis, metabolic acidosis, or both) |
Alkali administration with reduced kidney function |
Calcium-alkali syndrome* |
Bicarbonate ingestion/infusion with impaired kidney function |
Cystic fibrosis |
"Contraction" alkalosis (ie, loss of sodium-rich, bicarbonate-low fluid) |