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Hyperchloremic acidosis

Field	Value
name	Hyperchloremic acidosis

Hyperchloremic acidosis is a form of metabolic acidosis associated with a normal anion gap, a decrease in plasma bicarbonate concentration, and an increase in plasma chloride concentration (see anion gap for a fuller explanation). Although plasma anion gap is normal, this condition is often associated with an increased urine anion gap, due to the kidney's inability to secrete ammonia.

Causes

In general, the cause of a hyperchloremic metabolic acidosis is a loss of base, either a gastrointestinal loss or a renal loss.

Gastrointestinal loss of bicarbonate ()
- Severe diarrhea (vomiting will tend to cause hypochloraemic alkalosis)
- Pancreatic fistula with loss of bicarbonate rich pancreatic fluid
- Nasojejunal tube losses in the context of small bowel obstruction and loss of alkaline proximal small bowel secretions
- Chronic laxative abuse
Renal causes
- Proximal renal tubular acidosis with failure of resorption
- Distal renal tubular acidosis with failure of secretion
- Long-term use of a carbonic anhydrase inhibitor such as acetazolamide
Other causes
- Ingestion of ammonium chloride, hydrochloric acid, or other acidifying salts
- The treatment and recovery phases of diabetic ketoacidosis
- Volume resuscitation with 0.9% normal saline provides a chloride load, so that infusing more than 3–4L can cause acidosis
- Hyperalimentation (i.e., total parenteral nutrition)

References

(2017-10-19). "Hyperchloremic Acidosis: Practice Essentials, Etiology, Patient Education".

Info: Wikipedia Source

This article was imported from Wikipedia and is available under the Creative Commons Attribution-ShareAlike 4.0 License. Content has been adapted to SurfDoc format. Original contributors can be found on the article history page.

acid–base-disturbances electrolyte-disturbances

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