Metabolic Alkalosis

Increased plasma bicarbonate and a blood pH above 7.45.

Written by: Saygı Hospital Health Guide Editorial Board

Last updated: June 10, 2026

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Metabolic Alkalosis?

Metabolic alkalosis is an acid-base disorder defined by increased plasma bicarbonate and blood pH above 7.45. It is divided into 'chloride-responsive' and 'chloride-resistant' subgroups.

The most common causes of chloride-responsive alkalosis (urine chloride <20 mEq/L) are vomiting and diuretics; it resolves with normal saline. The chloride-resistant type (urine chloride >20 mEq/L) is seen in primary hyperaldosteronism, Cushing syndrome, and Bartter/Gitelman syndromes.

Severe alkalosis (pH >7.6) can cause respiratory depression, seizures, and arrhythmias; it can produce tetany by lowering ionized calcium.

Symptoms

Muscle cramps and tetany

Paresthesia (tingling, numbness)

Confusion and weakness

Shallow and slow respirations

Palpitations and arrhythmia

Headache

Seizure (in severe cases)

Risk Factors

Prolonged vomiting and nasogastric suction

Use of loop or thiazide diuretics

Primary hyperaldosteronism

Cushing syndrome

Excessive alkali intake (bicarbonate, milk-alkali syndrome)

Bartter and Gitelman syndromes

Hypokalemia

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

Weakness with prolonged vomiting
Symptoms of muscle cramps and tetany
New symptoms during diuretic therapy
Seizure or impaired consciousness (emergency)
Symptoms of arrhythmia

Treatment Methods

Treatment of the underlying cause

IV 0.9% NaCl infusion in chloride-responsive alkalosis

Potassium replacement if hypokalemia is present

Review of diuretic therapy

Spironolactone, amiloride in chloride-resistant alkalosis

Acetazolamide or HCl infusion in severe cases

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.