Use

Evaluate electrolyte composition of urine, acid-base balance studies. Distinguish whether or not a case of metabolic alkalosis is chloride-responsive (salt responsive). Sherman and Eisinger1,2 discuss bicarbonate excretion, blood volume, potassium depletion, and the differential diagnosis of metabolic alkalosis with loss of gastric juice (emesis, intubation) and after diuretics. Chloride depleted patients excrete urine with low chloride, <10 mmol/L. Such patients are chloride-responsive (ie, they respond to chloride sufficient to return body stores to normal). Metabolic alkalosis with low urine chloride is also found with villous tumors of the colon.