Acid and alkali loads
Acid loads |
CO2: Respiratory acidosis |
Nonvolatile acids: Metabolic acidosis |
Exogenous acids (e.g., salicylate, methanol, and ethylene glycol) |
Pathologic endogenous acids (e.g., ketoacids and lactic acid) |
Decreased renal acid excretion (e.g., renal failure and distal renal tubular acidosis) |
Loss of alkali, equivalent to acid load |
Gastrointestinal losses (e.g., diarrhea) |
Urine losses (e.g., proximal renal tubular acidosis) |
Alkali loads |
Excess CO2 exhalation: Respiratory alkalosis |
Nonvolatile alkali: Metabolic alkalosis |
Exogenous alkali (e.g., NaHCO3 administration) |
Loss of acid, equivalent to alkali load |
Gastrointestinal losses (e.g., gastric fluid) |
Excess urine H+ losses and renal production of new HCO3− (most classic causes of metabolic alkalosis, including chloride depletion metabolic alkalosis and mineralocorticoid excess) |