Causes low potassium alkalosis

Pathogenesis

In the case of a metabolic alkalosis, the pH value of the blood has risen above 7.45 due to an increase in bicarbonate (see below addition alkalosis) or the loss of hydrogen ions (see below subtraction alkalosis).

Possible causes of metabolic alkalosis are oneAddition alkalosis and a Subtraction alkalosis: Metabolic alkalosis can be caused by either one increased intake or production of bases (Bicarbonates) arise in the metabolism (Addition alkalosis) or through increased Loss of acids(Subtraction alkalosis).

A Addition alkalosis can be caused by the intake of alkaline substances:

  • Citrate
  • Sodium bicarbonate
  • Lactate

Common causes of a Subtractive alkalosis are:

  • Loss of chloride and / or volume:
    • Drainage of gastric juice
    • Chronic vomiting (loss of acidic gastric juice (stomach acid; about 0.5 percent hydrochloric acid on an empty stomach) and, in particular, of chloride, resulting in hypochloraemic alkalosis)
    • Gastric lavage
  • Long-term medication:
    • Mineralocorticoids
    • Furosemide and hydrochlorothiazide (HCT) (loss of potassium → hypokalaemia (potassium deficiency); therefore preferably: potassium-sparing diuretic (e.g. spironolactone)

etiology

Biographical causes

  • Genetic strain by parents, grandparents - among other things - or that
  • Genetic diseases
    • Bartter syndrome - a very rare genetic metabolic disorder with autosomal dominant or autosomal recessive or X-linked recessive inheritance; Defect of tubular transport proteins; Hyperaldosteronism (conditions associated with an increased release of aldosterone), hypokalaemia (lack of potassium) and hypotension (low blood pressure)
    • Gitelman syndrome (GS; synonym: familial hypokalemia-hypomagnesaemia) - a genetic disease with an autosomal recessive inheritance, which is characterized by a hypokalemic metabolic alkalosis (metabolism-related alkalosis with potassium deficiency) with pronounced hypomagnesaemia (magnesium deficiency) and low calcium excretion in the urine

Behavioral causes

  • Increased alkali intake
  • liquorice
  • chewing tobacco
  • Black cohosh (medicinal plant)

Disease-related causes

  • Drainage of gastric juice
  • Bartter syndrome - a very rare metabolic disease, which is mainly associated with hyperaldosteronism and, as a result, with hypokalaemia (potassium deficiency)
  • Chronic vomiting - loss of acidic gastric juice
  • Endocrine disorders - e.g. B. Hyperaldosteronism (resulting in hypokalaemia (lack of potassium)
  • Gitelman syndrome - a genetic disease that results in an increased loss of potassium and magnesium from the kidneys
  • Hypercalcaemia (excess calcium)
  • Hyperparathyroidism (overactive parathyroid glands)
  • Congenital chlorideorrhea - diarrhea caused by chloride malabsorption
  • Liddle syndrome - very rare genetic disease associated with hypertension (high blood pressure)
  • Gastric lavage
  • Malnutrition (malnutrition) → extrarenal potassium loss ("outside the kidneys")
  • Milk-Alkali Syndrome (Burnett's Syndrome) - a disease caused by an excess of alkalis such as milk and calcium carbonate; clinical picture: nausea (nausea) / vomiting, vertigo (dizziness) and ataxia (gait disturbance); Laboratory diagnostics: alkalosis with hypercalcaemia (excess potassium) without increased excretion of calcium in the urine and without a drop in the phosphate content in the blood; Hypercalcemia leads to calcinosis (calcium salt deposits) of the conjunctiva, the cornea of ​​the eyes ("band keratitis" of the eyelid fissure) and in the renal tubules with the risk of renal insufficiency (slowly progressive reduction in kidney function)
  • Cushing's disease - group of diseases that lead to hypercortisolism (hypercortisolism) - excess supply of cortisol
  • Adrenal enzyme defects such as hydroxylase deficiency
  • Renal artery stenosis - narrowing of the renal artery (s) causing hypertension (high blood pressure)
  • Edema - accumulation of water in the tissues
  • Primary aldosteronism (overproduction of aldosterone) caused by a tumor or hyperplasia
  • Tumors that produce renin (an enzyme that regulates blood pressure)
  • Villous adenoma - benign tumor

Laboratory diagnoses - laboratory parameters that are considered independent risk factors

  • Hypercalcaemia (excess calcium)
  • Hypokalaemia (lack of potassium)
  • Hypomagnesaemia (magnesium deficiency)

Medication

  • Treatment with mineralocorticoids (loss of potassium)
  • Diuretics (water medicines) - such as furosemide and hydrochlorothiazide (loss of potassium); therefore preferably a potassium-sparing diuretic (e.g. spironolactone)
  • Laxatives → extrarenal potassium loss
  • Penicillin, carbenicillin (antibiotics)
     
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