Metabolic effects

Metabolic effects

V omiting hydrochloric acid results in hypochloraemic alkalosis. Initially the sodium and potassium may be relatively normal; however, as dehydration progresses, more profound metabolic abnormalities arise, partly related to renal dysfunction. Initially , the urine has a low chloride and high bicarbonate content, reflecting the primary metabolic abnormality . With time the patient becomes progressively hyponatraemic and more profoundly dehydrated. Because of the dehydration, sodium is retained and potassium and hydrogen ions are excreted. This results in the urine becoming paradoxically acidic and hypokalaemia ensues. Alkalosis leads to a lowering in the circulating ionised calcium, and tetany can occur.