| Generation | Examples |
|---|---|
| Loss of Acid from the Extracellular Space | |
| Loss of gastric fluid (HCl) | Vomiting |
| Acid loss in urine; increased distal sodium delivery in the presence of hyperaldosteronism | Primary aldosteronism plus diuretic |
| Acid shifts into cells | Potassium deficiency |
| Loss of acid into stool | Congenital chloride-losing diarrhea |
| Excessive Bicarbonate Loads | |
| Absolute | |
| Oral or parenteral bicarbonate | Milk alkali syndrome |
| Metabolic conversion of the salts of organic acids to bicarbonate | Lactate, acetate, or citrate administration |
| Relative | Sodium bicarbonate dialysis |
| Posthypercapnic states | Correction (mechanical ventilatory support) of chronic hypercapnia |