Alkali Administration
Under normal circumstances, any excess alkali which may be ingested is rapidly excreted by the kidneys. However it can contribute to the problem under certain circumstances:
- In patients who are potassium or chloride depleted
- In patients with renal insufficiency, where the excess alkali cannot be excreted. This occurs in milk-alkali syndrome.
In milk-alkali syndrome, there is simultaneous intake of sodium bicarbonate and excess calcium. Alkalinization of the urine leads to calcium precipitation, which leads in turn to kidney damage. The renal impairment perpetuates the alkaline state and the process continues.