Chloride-Responsive Metabolic Alkalosis
Chloride-responsive alkaloses are commonly caused by loss of protons versus
gain of bicarbonate. Two common situations in which this occurs are
loss of acidic gastric fluid (often with accompanying volume contraction,
see also dehydration) and diuretic therapy. An uncommon cause is
loss of chloride in the sweat of patients with cystic fibrosis or dietary
deficiency of chloride (rare).
As you would expect, serum chemistry shows a low chloride concentration,
with a compensatorily high bicarbonate. Since the person is chloride-depleted,
their kidneys should preferentially retain chloride. If their kidneys
are functioning correctly, the urinary chloride concentration should be
less than 10 mEq/L.
Please direct all comments to: 
Last modification: April 30, 1998
