Why does paradoxical aciduria occur in pyloric stenosis?
Why does paradoxical aciduria occur in pyloric stenosis?
The kidneys attempt to maintain normal pH by excreting excess HCO3. The kidneys attempt to conserve sodium at the expense of hydrogen ions, which can lead to paradoxical aciduria. In more severe dehydration, renal potassium losses are also accelerated owing to an attempt to retain fluid and sodium.
Why does paradoxical aciduria occur?
Abstract. Paradoxical aciduria typically occurs as a result of metabolic alkalosis and intrinsic mechanisms to correct acid-base imbalances. It most commonly develops in the setting of pathologies which result in excessive gastric acid losses and is often associated with severe metabolic derangements.
What happens paradoxical aciduria?
This situation arises from the primary loss of gastric acid from repeated vomiting or drainage resulting in loss of chloride and potassium ions, as well as volume. Despite the metabolic alkalosis, the body still produces an acidic urine. The specific situation in this scenario is called “paradoxical aciduria”.
Why there is paradoxical aciduria in metabolic alkalosis?
Paradoxic aciduria can be a feature of a primary metabolic alkalosis due to vomiting or sequestration of hydrochloric acid-rich gastric contents in all species, but particularly ruminants.
Why is there paradoxical aciduria in gastric outlet obstruction?
Paradoxic aciduria occurs in hypertrophic pyloric stenosis and in adults with gastric outlet obstruction. The kidney puts a priority on maintaining volume by reabsorbing sodium ions in exchange for hydrogen ions. Therefore despite metabolic alkalosis, the urine may be acid.
Why is urine acidic in pyloric stenosis?
INFANTS WITH PYLORIC STENOSIS The excess loss of Cl depletes extracellular chloride and with the luminal loss of Hydrogen ions produces a metabolic alkalosis. The kidney tries to initially maintain blood pH by excreting an alkaline urine.
Why is there metabolic alkalosis in pyloric stenosis?
Why does pyloric stenosis cause hyponatremia?
This prolonged vomiting causes progressive loss of fluids rich in hydrochloric acid, which causes the kidneys to retain hydrogen ions in favor of potassium. The dehydration may result in hypernatremia or hyponatremia and may result in prerenal renal failure.
Why does pyloric stenosis cause non bilious vomiting?
Babies with pyloric stenosis usually have progressively worsening vomiting during their first weeks or months of life. The vomiting is often described as non bilious and projectile vomiting, because it is more forceful than the usual spit ups commonly seen at this age.
Why does pyloric stenosis cause metabolic alkalosis?
Pyloric stenosis usually results in metabolic alkalosis with associated hypochloremia and hypokalemia due to a loss of hydrogen and chloride ions from vomiting gastric contents. However, if the dehydration is severe enough, paradoxical aciduria may occur.
What is the pathophysiology of pyloric stenosis?
The hallmark of pyloric stenosis is marked hypertrophy and hyperplasia of both the circular and longitudinal muscular layers of the pylorus. [3] This thickening leads to the narrowing of the lumen of the gastric antrum. The pyloric canal becomes lengthened. The muscles of the pylorus become thickened.
Why is there hypokalemia in pyloric stenosis?
Pyloric stenosis usually results in metabolic alkalosis with associated hypochloremia and hypokalemia due to a loss of hydrogen and chloride ions from vomiting gastric contents.
What are the cardinal findings of pyloric stenosis?
The cardinal findings in pyloric stenosis are dehydration, metabolic alkalosis, hypochloremia, and hypokalaemia. Loss of gastric fluid leads to volume depletion and loss of sodium, chloride, acid (H+) and potassium. This results in a hypokalemic, hypochloremic metabolic alkalosis. The kidneys attempt to maintain normal pH by excreting excess
What is the treatment for Pyloric stenosis?
Pyloric Stenosis is a medial emergency that requires urgent fluid resuscitation and resolution of biochemical abnormalities. Definitive surgical treatment can then be undertaken to restore enteral nutrition.
What causes hypochloremic metabolic alkalosis and pyloric stenosis?
Due to the loss of hydrochloric acid in the gastric contents from persistent vomiting, patients are at risk of electrolyte imbalance, specifically the characteristic hypochloremic metabolic alkalosis. Pyloric stenosis is the result of both hyperplasia and hypertrophy of the pyloric circular muscle fibers.
What is hypertrophic pyloric stenosis?
Pyloric stenosis. Hypertrophic pyloric stenosis (HPS) refers to the idiopathic thickening of gastric pyloric musculature which then results in progressive gastric outlet obstruction.