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In general, the cause of a hyperchloremic metabolic acidosis is a loss of base, either a gastrointestinal loss or a renal loss [citation needed]. Gastrointestinal loss of bicarbonate (HCO − 3) [citation needed] Severe diarrhea (vomiting will tend to cause hypochloraemic alkalosis) Pancreatic fistula with loss of bicarbonate rich pancreatic fluid
The impact of the Stewart analysis has been slow in coming but there has been a recent resurgence in interest, particularly as this approach provides explanations for several areas which are otherwise difficult to understand (e.g., dilutional acidosis, acid–base disorders related to changes in plasma albumin concentration).
Acidosis is a biological process producing hydrogen ions and increasing their concentration in blood or body fluids. pH is the negative log of hydrogen ion ...
Metabolic acidosis can lead to acidemia, which is defined as arterial blood pH that is lower than 7.35. [6] Acidemia and acidosis are not mutually exclusive – pH and hydrogen ion concentrations also depend on the coexistence of other acid-base disorders; therefore, pH levels in people with metabolic acidosis can range from low to high.
Hyperparathyroidism – can cause hyperchloremia and increase renal bicarbonate loss, which may result in a normal anion gap metabolic acidosis. Patients with hyperparathyroidism may have a lower than normal pH, slightly decreased PaCO2 due to respiratory compensation, a decreased bicarbonate level, and a normal anion gap.
High anion gap metabolic acidosis is a form of metabolic acidosis characterized by a high anion gap (a medical value based on the concentrations of ions in a patient's serum). Metabolic acidosis occurs when the body produces too much acid , or when the kidneys are not removing enough acid from the body.
Excretion is the most common cause of hypokalemia and can be caused by diuretic use, metabolic acidosis, diabetic ketoacidosis, hyperaldosteronism, and renal tubular acidosis. [3] Potassium can also be lost through vomiting and diarrhea. [14]
Diagnosis of contraction alkalosis is made by correlating laboratory data with clinical history and examination. Metabolic alkalosis in the presence of decreased effective circulatory volume, loop diuretic use, or other causes of intravascular depletion such as profound diarrhea should raise suspicion for contraction alkalosis as a likely etiology in the absence of other causes.