Metabolic Alkalosis Differential Diagnoses

  • Author: Sameer Yaseen, MD; Chief Editor: Vecihi Batuman, MD, FACP, FASN   more...
 
Updated: Nov 3, 2011
 
 

Diagnostic Considerations

Severe metabolic alkalosis is a life-threatening condition; recognizing and treating the condition appropriately is important. The diagnosis of metabolic alkalosis is difficult to miss in patients in the intensive care unit (ICU) because arterial blood gases (ABGs) are measured routinely in most of these patients.

In non-ICU patients, metabolic alkalosis is suspected if electrolytes show an elevated carbon dioxide level. An elevated carbon dioxide level may also be secondary to respiratory acidosis. Because treatments for the 2 conditions differ, differentiating between them by reviewing the clinical condition of the patient and performing ABGs if the elevation in carbon dioxide is severe is important. In addition, check serum K+ and ionized Ca2+ because metabolic alkalosis is often associated with hypokalemia and decreased serum ionized Ca2+ levels.

For a discussion of metabolic alkalosis in children, see Pediatric Metabolic Alkalosis. For a general review of acid-base regulation, see Metabolic Acidosis.

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Sameer Yaseen, MD  Staff Nephrologist, Department of Internal Medicine, Division of Nephrology, Mercy Hospital of Des Moines

Sameer Yaseen, MD is a member of the following medical societies: American Society of Nephrology and Renal Physicians Association

Disclosure: Nothing to disclose.

Coauthor(s)

Christie P Thomas, MBBS, FRCP, FASN, FAHA  Professor, Department of Internal Medicine, Division of Nephrology, Medical Director, Kidney and Kidney/Pancreas Transplant Program, University of Iowa Hospitals and Clinics

Christie P Thomas, MBBS, FRCP, FASN, FAHA is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Heart Association, American Society of Nephrology, American Society of Transplantation, American Thoracic Society, International Society of Nephrology, and Royal College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Vecihi Batuman, MD, FACP, FASN  Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Medicine Service, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, and International Society of Nephrology

Disclosure: Nothing to disclose.

Additional Contributors

Eleanor Lederer, MD Professor of Medicine, Chief, Nephrology Division, Director, Nephrology Training Program, Director, Metabolic Stone Clinic, Kidney Disease Program, University of Louisville School of Medicine; Consulting Staff, Louisville Veterans Affairs Hospital

Eleanor Lederer, MD is a member of the following medical societies: American Association for the Advancement of Science, American Federation for Medical Research, American Society for Biochemistry and Molecular Biology, American Society for Bone and Mineral Research, American Society of Nephrology, American Society of Transplantation, International Society of Nephrology, Kentucky Medical Association, National Kidney Foundation, and Phi Beta Kappa

Disclosure: Dept of Veterans Affairs Grant/research funds Research

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References

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Algorithm for metabolic alkalosis.
 
 
 
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