Diuretics

Diuretics which act by blocking chloride-linked sodium reabsorption in the loop of Henle and early distal tubule can lead to metabolic alkalosis.  These include:

1. Loop diuretics (furosemide) which block the Na⁺/K⁺/2Cl^- transporter

2. Thiazide diuretics which block the NaCl cotransporter

There is concurrent loss of H⁺ and K⁺ secondary to fluid depletion.

This problem may be part of the desired therapeutic response and the usual response is supplementation with KCl or co-administration of a potassium-sparing diuretic.

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