Hyperkalaemic Metabolic Alkalosis

Key points

• Cushing's syndrome classically causes a hypokalaemic metabolic alkalosis
• excess cortisol acts on mineralocorticoid receptors, driving potassium loss and bicarbonate retention
• The differential for a HYPOKALAEMIC METABOLIC ALKALOSIS with HYPERTENSION includes Cushing's syndrome, primary hyperaldosteronism (Conn's), renal artery stenosis and liquorice excess · WITHOUT hypertension it includes vomiting, diuretics, and Bartter's and Gitelman's syndromes.