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Alkalosis

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

Causes

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) 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 levels in the blood. This can be due to:

  • Fever
  • Being at a high altitude
  • Lack of oxygen
  • Liver disease
  • Lung disease, which causes you to breathe faster (hyperventilate )
  • Salicylate poisoning

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:

  • Confusion (can progress to stupor or coma)
  • Hand tremor
  • Light-headedness
  • Muscle twitching
  • Nausea, vomiting
  • Numbness or tingling in the face, hands, or feet
  • Prolonged muscle spasms (tetany)

Exams and Tests

The doctor 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 health care provider needs to find the 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 health care provider will monitor your vital signs (temperature, pulse, rate of breathing, 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 health care 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:

  • Loss of consciousness
  • Rapidly worsening symptoms of alkalosis
  • Severe breathing difficulties

Prevention

Prevention depends on the cause of the alkalosis. Normally, people with healthy kidneys and lungs do not have serious alkalosis.

References

Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 120.

Updated: 11/7/2013

Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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