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Disease relevance of Alkalosis


Psychiatry related information on Alkalosis

  • Patients with panic disorder may have hypersensitive CO2 receptors that, when triggered, evoke a subjective panic associated with an exaggerated ventilatory response and consequent hypocapnic alkalosis [6].

High impact information on Alkalosis

  • Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na-K-2Cl cotransporter NKCC2 [7].
  • Gitelman's variant of Bartter's syndrome, inherited hypokalaemic alkalosis, is caused by mutations in the thiazide-sensitive Na-Cl cotransporter [8].
  • Alkalosis from chloride-deficient Neo-Mull-Soy [9].
  • This fall in pHi and the extracellular alkalosis are attributable to a GABA-activated, picrotoxin-sensitive HCO3--conductance [10].
  • Carbenicillin-associated hypokalemic alkalosis [11].

Chemical compound and disease context of Alkalosis

  • Studies were undertaken in Munich-Wistar rats to determine whether maintenance of chronic metabolic alkalosis (CMA) is associated with an increase in proximal HCO3- reabsorption, or whether a reduction in glomerular filtration rate (GFR) is required to sustain the elevated plasma HCO3- concentration [12].
  • When single nephron GFR during alkalosis was increased toward normal by isohydric volume expansion or in another group by isotonic bicarbonate loading, absolute proximal bicarbonate reabsorption was not substantially augmented and bicarbonaturia developed [13].
  • In the principal cell there was no evidence for apical Cl-/HCO3- exchange, including no change in pHi with increases in luminal HCO3-. The principal cell possesses a basolateral Cl-/HCO3- exchanger that is inactive normally but stimulated by intracellular alkalosis [14].
  • Although both maneuvers partially corrected metabolic alkalosis, sodium chloride raised serum chloride concentration while mannitol significantly decreased it [15].
  • Hydrochloric acid for metabolic alkalosis [16].

Biological context of Alkalosis

  • Thus, hypocapnic alkalosis due to hyperventilation interferes with myocardial O2 supply by 1) coronary vasoconstriction and 2) increased O2 affinity of blood [17].
  • The rise in lactate together with an increase in pH suggest that intracellular alkalosis, caused by the shift of creatine kinase, selectively stimulated glycolysis [18].
  • In the tubule model, diminished Na+/H+ exchange in alkalosis blunts the axial decrease in luminal HCO3- and thus diminishes paracellular reabsorption of Cl-. In this way, the kinetics of the Na+/H+ antiporter could act to enhance distal delivery of Na+, Cl-, and HCO3- in acute metabolic alkalosis [19].
  • It is found that the ability to sharply turn off Na+/H+ exchange in cellular alkalosis substantially eliminates the cell volume increase associated with high HCO3- conditions [19].
  • The role of chloride deficiency in the generation of hypokalemic metabolic alkalosis with elevated plasma renin activity and plasma aldosterone levels, normal blood pressure, and a renal concentrating defect was studied in six infants given a soy formula that was deficient in chloride [20].

Anatomical context of Alkalosis


Gene context of Alkalosis


Analytical, diagnostic and therapeutic context of Alkalosis


  1. Genetic heterogeneity of Bartter's syndrome revealed by mutations in the K+ channel, ROMK. Simon, D.B., Karet, F.E., Rodriguez-Soriano, J., Hamdan, J.H., DiPietro, A., Trachtman, H., Sanjad, S.A., Lifton, R.P. Nat. Genet. (1996) [Pubmed]
  2. Acute metabolic alkalosis perpetuating hypercarbia. A role for acetazolamide in chronic obstructive pulmonary disease. Miller, P.D., Berns, A.S. JAMA (1977) [Pubmed]
  3. Failure to thrive and metabolic alkalosis. Adverse effects of a chloride-deficient formula in two infants. Wolfsdorf, J.I., Senior, B. JAMA (1980) [Pubmed]
  4. Influence of steady-state alterations in acid-base equilibrium on the fate of administered bicarbonate in the dog. Adrogué, H.J., Brensilver, J., Cohen, J.J., Madias, N.E. J. Clin. Invest. (1983) [Pubmed]
  5. Human and murine phenotypes associated with defects in cation-chloride cotransport. Delpire, E., Mount, D.B. Annu. Rev. Physiol. (2002) [Pubmed]
  6. Ventilatory physiology of patients with panic disorder. Gorman, J.M., Fyer, M.R., Goetz, R., Askanazi, J., Liebowitz, M.R., Fyer, A.J., Kinney, J., Klein, D.F. Arch. Gen. Psychiatry (1988) [Pubmed]
  7. Bartter's syndrome, hypokalaemic alkalosis with hypercalciuria, is caused by mutations in the Na-K-2Cl cotransporter NKCC2. Simon, D.B., Karet, F.E., Hamdan, J.M., DiPietro, A., Sanjad, S.A., Lifton, R.P. Nat. Genet. (1996) [Pubmed]
  8. Gitelman's variant of Bartter's syndrome, inherited hypokalaemic alkalosis, is caused by mutations in the thiazide-sensitive Na-Cl cotransporter. Simon, D.B., Nelson-Williams, C., Bia, M.J., Ellison, D., Karet, F.E., Molina, A.M., Vaara, I., Iwata, F., Cushner, H.M., Koolen, M., Gainza, F.J., Gitleman, H.J., Lifton, R.P. Nat. Genet. (1996) [Pubmed]
  9. Alkalosis from chloride-deficient Neo-Mull-Soy. Roy, S., Arant, B.S. N. Engl. J. Med. (1979) [Pubmed]
  10. Postsynaptic fall in intracellular pH induced by GABA-activated bicarbonate conductance. Kaila, K., Voipio, J. Nature (1987) [Pubmed]
  11. Carbenicillin-associated hypokalemic alkalosis. Cabizuca, S.V., Desser, K.B. JAMA (1976) [Pubmed]
  12. Load dependence of proximal tubular bicarbonate reabsorption in chronic metabolic alkalosis in the rat. Maddox, D.A., Gennari, F.J. J. Clin. Invest. (1986) [Pubmed]
  13. Metabolic alkalosis in the rat. Evidence that reduced glomerular filtration rather than enhanced tubular bicarbonate reabsorption is responsible for maintaining the alkalotic state. Cogan, M.G., Liu, F.Y. J. Clin. Invest. (1983) [Pubmed]
  14. Regulation of Cl-/HCO3- exchange in the rabbit cortical collecting tubule. Weiner, I.D., Hamm, L.L. J. Clin. Invest. (1991) [Pubmed]
  15. Effect of volume expansion on renal citrate and ammonia metabolism in KCl-deficient rats. Adler, S., Zett, B., Anderson, B., Fraley, D.S. J. Clin. Invest. (1975) [Pubmed]
  16. Hydrochloric acid for metabolic alkalosis. Rothe, K.F. Lancet (1983) [Pubmed]
  17. Impairment of myocardial O2 supply due to hyperventilation. Neill, W.A., Hattenhauer, M. Circulation (1975) [Pubmed]
  18. Effect of photic stimulation on human visual cortex lactate and phosphates using 1H and 31P magnetic resonance spectroscopy. Sappey-Marinier, D., Calabrese, G., Fein, G., Hugg, J.W., Biggins, C., Weiner, M.W. J. Cereb. Blood Flow Metab. (1992) [Pubmed]
  19. A kinetically defined Na+/H+ antiporter within a mathematical model of the rat proximal tubule. Weinstein, A.M. J. Gen. Physiol. (1995) [Pubmed]
  20. Hypokalemic metabolic alkalosis in normotensive infants with elevated plasma renin activity and hyperaldosteronism: role of dietary chloride deficiency. Roy, S., Arant, B.S. Pediatrics (1981) [Pubmed]
  21. Effects of chloride and extracellular fluid volume on bicarbonate reabsorption along the nephron in metabolic alkalosis in the rat. Reassessment of the classical hypothesis of the pathogenesis of metabolic alkalosis. Galla, J.H., Bonduris, D.N., Luke, R.G. J. Clin. Invest. (1987) [Pubmed]
  22. Glutamine transport and metabolism by mitochondria from dog renal cortex. General properties and response to acidosis and alkalosis. Simpson, D.P., Adam, W. J. Biol. Chem. (1975) [Pubmed]
  23. Acidosis, alkalosis, and aqueous humor dynamics in rabbits. Krupin, T., Oestrich, C.J., Bass, J., Podos, S.M., Becker, B. Invest. Ophthalmol. Vis. Sci. (1977) [Pubmed]
  24. Effect of induced metabolic alkalosis on human skeletal muscle metabolism during exercise. Hollidge-Horvat, M.G., Parolin, M.L., Wong, D., Jones, N.L., Heigenhauser, G.J. Am. J. Physiol. Endocrinol. Metab. (2000) [Pubmed]
  25. Pulmonary artery catheter deterioration during hydrochloric acid infusion for the treatment of metabolic alkalosis. Kopel, R.F., Durbin, C.G. Crit. Care Med. (1989) [Pubmed]
  26. Intercalated cell H+/OH- transporter expression is reduced in Slc26a4 null mice. Kim, Y.H., Verlander, J.W., Matthews, S.W., Kurtz, I., Shin, W., Weiner, I.D., Everett, L.A., Green, E.D., Nielsen, S., Wall, S.M. Am. J. Physiol. Renal Physiol. (2005) [Pubmed]
  27. The Na-K-Cl cotransporters. Haas, M., Forbush, B. J. Bioenerg. Biomembr. (1998) [Pubmed]
  28. Ectopic production of ACTH and corticotropin-releasing hormone (CRH). Müller, O.A., von Werder, K. J. Steroid Biochem. Mol. Biol. (1992) [Pubmed]
  29. Regulation of the 11 beta-hydroxysteroid dehydrogenase in the rat adrenal. Decrease enzymatic activity induced by ACTH. Morita, H., Cozza, E.N., Zhou, M.Y., Gomez-Sanchez, E.P., Romero, D.G., Gomez-Sanchez, C.E. Endocrine (1997) [Pubmed]
  30. pH dependence of neutrophil-endothelial cell adhesion and adhesion molecule expression. Serrano, C.V., Fraticelli, A., Paniccia, R., Teti, A., Noble, B., Corda, S., Faraggiana, T., Ziegelstein, R.C., Zweier, J.L., Capogrossi, M.C. Am. J. Physiol. (1996) [Pubmed]
  31. Regulation of AE1 anion exchanger and H(+)-ATPase in rat cortex by acute metabolic acidosis and alkalosis. Sabolić, I., Brown, D., Gluck, S.L., Alper, S.L. Kidney Int. (1997) [Pubmed]
  32. Severe metabolic alkalosis complicating regional citrate hemodialysis. Kelleher, S.P., Schulman, G. Am. J. Kidney Dis. (1987) [Pubmed]
  33. Metabolic alkalosis in children undergoing cardiac surgery. Wong, H.R., Chundu, K.R. Crit. Care Med. (1993) [Pubmed]
  34. Treatment of metabolic alkalosis with intravenous infusion of concentrated hydrochloric acid. Kwun, K.B., Boucherit, T., Wong, J., Richards, Y., Bryan-Brown, C.W. Am. J. Surg. (1983) [Pubmed]
  35. Effects of respiratory and metabolic alkalosis and acidosis on pipecuronium neuromuscular block. Biró, K. Eur. J. Pharmacol. (1988) [Pubmed]
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