What is the focus of the clinical history to evaluate for metabolic alkalosis?

Updated: Dec 10, 2020
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

The clinical history is helpful in establishing the etiology. Important points in the history include the following:

  • Vomiting or diarrhea - Gastrointestinal (GI) losses of hydrochloric acid (HCl)

  • Age of onset and family history of alkalosis - Familial disorders (eg, Bartter syndrome, which starts during childhood)

  • Renal failure - Alkali-loading alkalosis develops only when impairment of renal function occurs

  • Drug use (eg, loop or thiazide diuretics; licorice; tobacco chewing; carbenoxolone; fludrocortisone; glucocorticoids; antacids [eg, magnesium hydroxide]; calcium carbonate)

  • Previous GI surgery [9] (eg, ileostomy [10] )


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