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Alkalosis

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Alkalosis is a condition in which the body fluids have excess base (alkali). This is the opposite of excess acid (acidosis).

The kidneys and lungs maintain the proper balance (proper pH level) of chemicals called acids and bases in the body. Decreased carbon dioxide (an acid) level or increased bicarbonate (a base) level makes the body too alkaline, a condition called alkalosis. There are different types of alkalosis. These are described below.

Respiratory alkalosis is caused by a low carbon dioxide level in the blood. This can be due to:

Metabolic alkalosis is caused by too much bicarbonate in the blood. It can also occur due to certain kidney diseases.

Hypochloremic alkalosis is caused by an extreme lack or loss of chloride, such as from prolonged vomiting.

Hypokalemic alkalosis is caused by the kidneys' response to an extreme lack or loss of potassium. This can occur from taking certain water pills (diuretics).

Compensated alkalosis occurs when the body returns the acid-base balance to normal in cases of alkalosis, but bicarbonate and carbon dioxide levels remain abnormal.

Symptoms

Symptoms of alkalosis can include any of the following:

Exams and Tests

The health care provider will perform a physical exam and ask about your symptoms.

Laboratory tests that may be ordered include:

Other tests may be needed to determine the cause of the alkalosis. These may include:

Treatment

To treat alkalosis, your provider needs to first find the underlying cause.

For alkalosis caused by hyperventilation, breathing into a paper bag allows you to keep more carbon dioxide in your body, which improves the alkalosis. If your oxygen level is low, you may receive oxygen.

Medicines may be needed to correct chemical loss (such as chloride and potassium). Your provider will monitor your vital signs (temperature, pulse, rate of breathing, and blood pressure).

Outlook (Prognosis)

Most cases of alkalosis respond well to treatment.

Possible Complications

Untreated or not treated properly, complications may include any of the following:

When to Contact a Medical Professional

Call your provider if you become confused, unable to concentrate, or unable to "catch your breath."

Go to the emergency room or call the local emergency number (such as 911) if there is:

Prevention

Prevention depends on the cause of the alkalosis. People with healthy kidneys and lungs do not usually have serious alkalosis.

References

Little M. Metabolic emergencies. In: Cameron P, Jelinek G, Kelly A-M, Brown A, Little M, eds. Textbook of Adult Emergency Medicine. 4th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015:chap 12.

Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 118.

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    Review Date: 11/20/2017

    Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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