What is the role of urine sodium ion concentration in the workup of 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

Measurement of urine sodium ion concentration is used in many conditions to determine volume status, especially in patients with oliguria. However, volume depletion in metabolic alkalosis may not lead to low urine sodium. In the first few days of vomiting, the loss of acidic gastric secretions leads to an increase in serum bicarbonate concentration. The kidneys try to excrete the excess bicarbonate as the sodium or potassium salt. Therefore, despite volume depletion, the urine sodium level may be inappropriately high.


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