Causes of Metabolic Alkalosis are Vomiting, Diarrhea, Diuretics, Cystic Fibrosis, Primary Hyperaldosteronism, Secondary hyperaldosteronism, laxative use, CKD, elactrolyte and nutritional imbalances, Milk-alkali syndrome, Blood transfusion, Genetic diseases for instances Bartter, Liddle, Gitelman syndrome etc. Among them, life threatening causes are loss of gastric acid, excessive use of loop and thiazide diuretics.

There are several causes of metabolic alkalosis. Life threatening causes of severe metabolic alkalosis (pH 7.55 to 7.65) may result in death (45% to 80%) or permanent disability within 24 hours if left untreated.^[1]

• Loss of gastric acid
• Loop or thiazide diuretics

• Chloride depletion or Gastrointestinal loss of hydrogen
  • GI loss: Vomiting (most commonly seen in pyloric stenosis), NG suction , Zollinger-ellison syndrome, Bulimia.^[2]
  • Diuretics: Loop and thiazide diuretics.
  • Diarrhea
  • Cystic fibrosis.^[3]
  • Chloride deficient infant formula.
• Potassium depletion or Mineralocorticoids excess or Renal loss of hydrogen
  • Dietary potassium depletion.^[4]
  • Primary hyperaldosteronism: Conn syndrome or adenoma, hyperplasia, carcinoma, renin or glucocorticoid responsive.
  • Secondary hyperaldosteronism: Reno vascular hypertension, edema (cirrhosis, heart failure, nephrotic syndrome), juxtaglomerular cell(renin producing) tumor, renal cell carcinoma, nephroblastoma
  • Mineralocorticoid excess due to primary decorticosterone excess (11 beta, 17 alpha hydroxylase deficiency), licorice(glycyrrhetinic acid) Closing </ref> missing for <ref> tag
  • congenital chloride diarrhea^[5]
  • Bartter and Gitelman syndrome. ^[6]
  • liddle syndrome</ref> ^[7]
  • hemangiopericytoma
  • Gastrocystoplasty ^[8]
  • Post hypercapneic metabolic alkalosis.