Primary metabolic alkalosis.

Primary metabolic alkalosis is a disorder caused by both precipitating and perpetuating mechanisms. Correction of the abnormality requires intervention at both levels. Diuretic therapy and prolonged nasogastric suctioning are the major precipitating events, while volume depletion is the most common aggravating factor. Treatment is directed toward correction of dehydration and removal of the precipitating cause when possible. If this does not suffice, hemodialysis with a high chloride dialysate, with or without hydrochloric acid infusion, is the treatment of choice.