Alkalosis

Alkalosis is a pathophysiological condition characterized by the buildup of excess base or alkali in the body, leading to an abnormally high serum pH (arterial pH >7.45), termed alkalemia. This condition represents one end of the acid-base disorder spectrum. There is generally a loss of hydrogen ions (H⁺) or an excess of bicarbonate ions (HCO₃⁻), with various factors potentially causing either of these mechanisms. Alkalosis can be as life-threatening as acidosis, and severe electrolyte derangements can accompany alkalosis due to transcellular shifts, potentially resulting in rare but severe clinical disorders.

Alkalosis can originate from either respiratory or metabolic causes, with metabolic alkalosis being more common. The renal and pulmonary systems are the primary regulators of serum pH levels. Respiratory alkalosis results in compensatory metabolic acidosis, whereas metabolic alkalosis results in compensatory respiratory acidosis. However, the pH does not typically correct to the normal value of 7.40. Pulmonary compensation is typically immediate, whereas renal compensation can take hours to days.