Metabolic alkalosis etiology

Metabolic alkalosis is characterized by an increased arterial pH, a primary increase in the HCOf concentration, and a compensatory increase in the PaC02. Patients will always hypoventilate to compensate for metabolic alkalosis—even if it results in profound hypoxemia. For a metabolic alkalosis to persist there must concurrently be a process that elevates serum HC03 concentration (gastric or renal loss of acids) and another that impairs renal HC03 excretion (hypovolemia, hypokalemia, or mineralocorticoid excess). The etiologies of metabolic alkalosis are listed in Table 25-5. 

Finally a rare etiology of CL resistant metabolic alkalosis is a genetic (autosomal recessive) defect in CL reabsorption within the thick ascending limb of the loop of Henle, a condition known as Bartter s syndrome. ... 

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