Table 1

. Etiologies of metabolic alkalosis

Chloride depletion
  • gastric losses: vomiting, mechanical drainage, bulimia

  • chloruretic diuretics: bumetanide, chlorothiazide, metolazone, etc.

  • diarrheal states: villous adenoma, congenital chloridorrhea

  • posthypercapneic state

  • dietary chloride deprivation with base loading: chloride-deficient infant formulas

  • gastrocystoplasty

  • cystic fibrosis (high sweat chloride)

Potassium depletion/mineralocorticoid excess
  • primary aldosteronism: adenoma, idiopathic, hyperplasia, renin-responsive, glucocorticoid-suppressible, carcinoma

  • apparent mineralocorticoid excess

    • primary deoxycorticosterone excess: 11β- and 17α-hydroxylase deficiencies

    • drugs: licorice (glycyrrhizic acid) as a confection or flavoring, carbenoxolone

    • Liddle syndrome

  • secondary aldosteronism

    • adrenal corticosteroid excess: primary, secondary, exogenous

    • severe hypertension: malignant, accelerated, renovascular

    • hemangiopericytoma, nephroblastoma, renal cell carcinoma

  • Bartter and Gitelman syndromes and their variants

  • laxative abuse, clay ingestion

Hypercalcemic states
  • hypercalcemia of malignancy

  • acute or chronic milk-alkali syndrome

  • carbenicillin, ampicillin, penicillin

  • bicarbonate ingestion: massive or with renal insufficiency

  • recovery from starvation

  • hypoalbuminemia