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"Saline Resistant" Metabolic Alkalosis, and Severe Potassium Depletion.

Serafino Garella, M.D.; Joseph A. Chazan, M.D.; and Jordan J. Cohen, M.D.
Ann Intern Med. 1969;70(5):1101. doi:10.7326/0003-4819-70-5-1101_2
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The common causes of metabolic alkalosis, diuretics, and loss of gastric acid produce both chlorine and potassium depletion, and both should be replaced during therapy. When potassium deficits are in the usual range (up to 450 mEq), however, it has been shown that the administration of sodium chloride without potassium results in chlorine retention by the kidney and repair of the acid-base abnormality; thus, moderate potassium depletion does not appear to be responsible for the alkalosis. Administered sodium chloride, however, does not result in chlorine retention by the kidney in patients with "saline-resistant" alkalosis. Such saline resistance is known to


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