- Chloride and K+ are also usually low. K+ is low as a result of the renal
loss and the intracellular shift.
Causes:
A- Renal:
1- Adrenocorticoid and adrenocorticoid-like effect (HCo 3 - retention
with K+ and H+ excretion).- Secondary aldosteronism (e.g. cirrhosis)
- Primary aldosteronism
- Cushing's syndrome
- Bartter's syndrome
- Liquorice ingestion
2- Volume depletion (Cl- depletion and HCo 3 - reabsorption) - diuretics • diarrhea • cirrhosis
B- Gastrointestinal loss of acid:
- Vomiting • Gastric aspiration
C- Ingestion of alkali:
- NaHCo 3
- Milk-alkali syndrome