Alkalosis - Frequently Asked Questions

Q: What is paradoxic aciduria?

A: In chronic metabolic alkalosis, the plasma bicarbonate levels exceed the ability of kidneys to excrete bicarbonate. At this stage, urine is acidic in the scenario of metabolic alkalosis.

Q: Which specialist treats acid base and electrolyte disturbances?

A: If the condition is not an emergency, you should consult a general physician. In more severe situations, the patient should be taken to the emergency room.

Q: Is alkalosis a common condition?

A: Metabolic alkalosis is a common condition. According to a study at least half of all acid base disorders are diagnosed to be metabolic alkalosis.

Q: Is alkalosis a life-threatening condition?

A: Alkalosis is not a life threatening condition. Most cases are diagnosed in the initial stages and cured without any longterm effects or complications.

Q: What is compensated metabolic alkalosis?

A: In metabolic alkalosis, the lungs try to compensate for the increased pH of the blood by retaining carbon dioxide through slowing the rate of respiration.(hypoventilation). Since CO₂ is acidic, increased levels of CO₂ in the blood will reduce the pH of the blood. Although respiratory compensation occurs, it is nevertheless incomplete.

Q: How does chloride depletion contribute to alkalosis?

A: In simple terms, loss of chloride, a negatively charged ion in turn stimulates reabsorption of bicarbonate (another negatively charged ion) by the kidneys.

As long as chloride ion remains depleted, alkalosis will not be corrected.

Q: How does low serum potassium cause alkalosis?

A: Low serum potassium causes an increase in bicarbonate reabsorption by the kidneys which in turn causes alkalosis.

Q: What are some of the commonly used groups of drugs that can cause metabolic alkalosis?

A: Diuretics, steroids, antacids and alkaline drugs such as bicarbonate if misused can lead to metabolic alkalosis.

Q: What is contraction alkalosis?

A: Contraction alkalosis occurs when there is loss of extracellular fluid (ECF) rich in chloride but not bicarbonate. This occurs with loop or thiazide diuretics and in diarrhea where increased amounts of chloride is lost in urine and stools respectively. As a result, there is reduction or contraction of the ECF volume. But since the original amount of bicarbonate is now dissolved in a smaller volume of the extracellular fluid, there is a relative increase in bicarb concentration, leading to alkalosis.

Q: What is the difference in treatments between chloride responsive and chloride resistant alkalosis?

A: Chloride responsive alkalosis responds to administration of chloride. This occurs when there has been excess chloride loss as in diuretic therapy or diarrhea.