Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted - 2° hyperaldosteronism
• Low Urine Cl-: Vomiting, NGT suction, Low Cl intake, Diuretics (late)
• High Urine Cl-: Diuretics, Bartter Syndrome, Gitelman Syndrome
Euvolemic* - 1°/2° hyperaldosteronism
• High PRA: Renal artery stenosis, Renin-secreting tumor
• Low PRA: Adenoma, BAH, AME, GRA, Cushing's syndrome, Liddle syndrome
PRA: plasma renin activity; AME: apparent mineralocorticoid excess; GRA: glucocorticoid remediable aldosteronism
*Due to aldosterone escape
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