Chapter VC3 - Diuretics in the Treatment of Metabolic Alkalosis

Abstract

Publisher Summary After correcting the underlying cause, the initial goal in the treatment of metabolic alkalosis is to remove those factors that are responsible for maintaining the alkalosis. In some circumstances, diuretic therapy may be the preferred method of achieving this goal. When utilizing this approach, however, one needs to consider carefully both the types of diuretic to be used, as well as the underlying condition that gave rise to the metabolic alkalosis. On the other hand, the potassium sparing diuretics are well suited to treating metabolic alkalosis that occurs in the setting of primary increases in mineralocorticoid activity. As a result, it is of paramount importance to be able to distinguish between those causes of metabolic alkalosis in which diuretic therapy is contraindicated and those conditions in which diuretics may be of clinical benefit. This chapter briefly reviews the pathogenesis of metabolic alkalosis and presents a categorization of clinical syndromes associated with metabolic alkalosis. It also focuses on those conditions in which diuretic therapy has proven to be of therapeutic benefit.