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Metabolic alkalosis is an acid-base disorder in which the pH of tissue is elevated beyond the normal range (7.35–7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate ( HCO − 3 ), or alternatively a direct result of increased bicarbonate concentrations.
Alkalosis is the result of a process reducing hydrogen ion concentration of arterial blood plasma (alkalemia).In contrast to acidemia (serum pH 7.35 or lower), alkalemia occurs when the serum pH is higher than normal (7.45 or higher).
The use of acidosis for a low pH creates an ambiguity in its meaning. The difference is important where a patient has factors causing both acidosis and alkalosis, wherein the relative severity of both determines whether the result is a high, low, or normal pH. [citation needed] Alkalemia occurs at a pH over 7.45.
Acidosis, defined by blood pH below 7.35, is the most common disorder of acid–base homeostasis and occurs when there is an excess of acid in the body. In contrast, alkalosis is characterized by excessively high blood pH. Blood pH is usually slightly basic, with a pH of 7.365, referred to as physiological pH in biology and medicine.
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
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.
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In respiratory acidosis, the kidney produces and excretes ammonium (NH 4 +) and monophosphate, generating bicarbonate in the process while clearing acid. There is also an excretion of Cl- and a reabsorption of sodium, resulting in a negative urinary anion gap. [5] In respiratory alkalosis, less bicarbonate (HCO 3 −) is reabsorbed, thus ...
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