Once the underlying pathology causing the metabolic acidosis is corrected, then the bicarbonate therapy will be responsible for a residual iatrogenic metabolic alkalosis . For all of the above reasons, bicarbonate therapy tends to be reserved for emergencies and situations where indications for therapy are compelling. As with metabolic acidosis, ideal treatment is the correction of the underlying abnormality. More active intervention is occasionally required and various techniques are available. Time, hydration, and renal function should gradually correct this.
Contraction alkalosis is one of the easier causes to understand and treat.
Dehydration concentrates the body's electrolytes. Intravenous dilute hydrochloric acid is occasionally used but carries the risk of hemolysis. Potassium chloride may also be used unless there is kidney failure. Ammonium chloride may be given my mouth except in liver failure. In severe potassium deficiency or hypermineralocorticoidism, metabolic alkalosis may not respond until the potassium is replaced.