Hyponatremic Chloride-depletion Metabolic Alkalosis Successfully Treated with High Cation-gap Amino Acid

Intern Med. 2016;55(13):1765-7. doi: 10.2169/internalmedicine.55.6356. Epub 2016 Jul 1.

Abstract

Chloride (Cl)-depletion alkalosis (CDA) develops due to the loss of Cl-rich body fluid, i.e., vomiting or diuretics use, and is typically treated with a chloride-rich solution such as normal saline (NS). Although NS is one of the most utilized Cl-rich solutions, high cation-gap amino acid (HCG-AA) predominantly comprises Cl and less sodium, making HCG-AA more efficient in correcting CDA. We herein report a case of CDA with chronic hyponatremia after frequent vomiting, which was successfully treated with HCG-AA without overcorrecting hyponatremia or causing hypervolemia. HCG-AA may be more beneficial than NS for treating hyponatremic or hypervolemic metabolic alkalosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alkalosis / drug therapy*
  • Alkalosis / etiology
  • Amino Acids / therapeutic use*
  • Chlorides / metabolism
  • Female
  • Humans
  • Hyponatremia / etiology*
  • Pregnancy
  • Sodium / metabolism
  • Vomiting / complications

Substances

  • Amino Acids
  • Chlorides
  • Sodium