TOPIC DISCUSSION: Maintenance of Metabolic Alkalosis

When there is vomiting: we get metabolic alkalosis due to H loss, we all know that!
What maintains that alkalosis and what causes the hypokalemia that we see with it? Often it's confused that there is K loss via GI track. Its not true

1. Hypovolemia continues to cause more Bicarbonate absorption
2. You have just activated the RENIN, angiotensin system leading to more met alkalosis
3. Activation of the system, leads to K loss in the urine.
4. Loss of Cl in the GI track allows for more Hco3 absorption

All these above methods lead to Maintenance of the Met Alkalosis in vomiting.