Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted - 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting, NGT suction, Low Cl intake, Diuretics (late)
 • High Urine Cl-: Diuretics, Bartter Syndrome, Gitelman Syndrome
Volume Expanded - 1° or 2° hyperaldosteronism
 • High PRA: Renal artery stenosis, Renin-secreting tumor
 • Low PRA: Adenoma, BAH, AME, GRA, Cushing's syndrome, Liddle syndrome

PRA: plasma renin activity; AME: apparent mineralocorticoid excess; GRA: glucocorticoid remediable aldosteronism

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