title: Hyponatremic Chloride-depletion Metabolic Alkalosis Successfully Treated with High Cation-gap Amino Acid.
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.
authors.affiliation: Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ryuge
authors.forename: Katsuomi
authors.initials: K
authors.lastname: Matsui
authors.forename: Yugo
authors.initials: Y
authors.lastname: Shibagaki
mesh_terms: D000328:Adult; D000471:Alkalosis / Q000188:drug therapy* / Q000209:etiology; D000596:Amino Acids / Q000627:therapeutic use*; D002712:Chlorides / Q000378:metabolism; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000209:etiology*; D011247:Pregnancy; D012964:Sodium / Q000378:metabolism; D014839:Vomiting / Q000150:complications
chemical_list: D000596:Amino Acids; D002712:Chlorides; D012964:Sodium