Renal ammonia metabolism is the predominant component of net acid excretion and new bicarbonate generation. Renal ammonia metabolism is regulated by acid-base balance. Both acute and chronic acid loads enhance ammonia production in the proximal tubule and secretion into the urine. In contrast, alkalosis reduces ammoniagenesis. Hypokalemia is a common electrolyte disorder that significantly incr...

This study was undertaken to investigate the effects of the potassium-retaining diuretic, amiloride, on the potassium balance and on the alkalosis which occurs in patients after open-heart surgery. Patients who had had valve replacement operations were divided randomly into two groups, one of which received Io mg amiloride daily in the postoperative period. Patients who were given amiloride nee...

Ectopic ACTH syndrome is a rare cause of Cushing's syndrome accounting for about 15% of all cases. Small cell lung cancer and bronchial carcinoids account for about half of the cases. Malignant neoplasm has rapid and more aggressive metabolic effects. We report a 54-year-old male patient with phenotypic features of Cushing's syndrome with severe hypokalemia, metabolic alkalosis, hypertension an...

1 Holland AE, Wilson JW, Kotsimbos TC, et al. Metabolic alkalosis contributes to acute hypercapnic respiratory failure in adult cystic fibrosis. Chest 2003; 124:490–493 2 Jones NL. Blood gases and acid-base physiology. 2nd ed. New York, NY: Thieme Medical Publishers, 1987 3 Mauri S, Pedroli G, Rudeberg A, et al. Acute metabolic alkalosis in cystic fibrosis: prospective study and review of the l...

Important and otherwise excellent articles by Weber1,2 and Schrier and Abraham3 strongly characterize persistent reninangiotensin-aldosterone system (RAAS) activation in congestive heart failure, a hypervolemic state, as “inappropriate” based on their view that the primary role of the RAAS is to prevent salt deprivation or intravascular volume contraction (hypovolemia). Actually, as the authors...

BACKGROUND Maternal electrolyte imbalance is rarely reported as causative factor of severe perinatal brain injury. CASE CHARACTERISTICS This case outlines a unique maternal and neonatal pseudo-Bartter syndrome presented with metabolic alkalosis and hypochloremia due to maternal severe vomiting. OBSERVATION Neonatal MRI brain revealed extensive brain hemorrhages with porencephalic cysts. Sub...

A 22 year-old lady with multi-drug-resistant pulmonary tuberculosis was on Kanamycin, Cycloserine, Ethionamide, Pyrazinamide and Moxifloxacin since more than two months. She presented with muscle cramps and carpopedal spasm. Investigation revealed hypokalemia and metabolic alkalosis. She also had hypomagnesemia, hypochloremia and hypocalciuria. Serum urea and creatinine levels were normal. Pati...