Furosemide will further impair sodium reabsorption and volume contraction, and in fact may worsen the metabolic alkalosis and may result in cardiac arrhythmias, and thus its use is not warranted. OVERVIEW. Metabolic alkalosis is a a primary acid-base disorder that causes the plasma bicarbonate to rise to an abnormally high level; the severity of a metabolic alkalosis is determined by the difference between the actual [HCO3] and the expected [HCO3] Hypokalemia → K+ are moving from lumen to the inside of cells → lumen is more negative than before → H+secreted out to the lumen to make up for the electrical neutrality (now lumen is not negative anymore) → metabolic alkalosis Case presentation. A 22-years-old female nurse with a body mass index 18 suffered from myalgias, vomiting and diarrhea. Blood tests revealed hypokalemia with a lowest value of 1.1 mmol/l, moderate hyponatremia, metabolic alkalosis, mild renal insufficiency and creatinphosphokinase-elevation. Effect of furosemide-induced hypokalemic metabolic alkalosis on renal transport enzymes. Hypokalemic metabolic alkalosis is one of the most common complications of chronic furosemide administration. Furosemide, sold under the brand name Lasix among others, is a medication used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. It may also be used for the treatment of high blood pressure. It can be taken by injection into a vein or by mouth. When taken by mouth, it typically begins working within an hour, while. Hypokalemia developed in both intact and ADX animals receiving furosemide. Thus, metabolic alkalosis in chronic furosemide therapy is associated with stimulation of all three collecting tubule ATPases. The high aldosterone level likely stimulates the H-ATPase in both CCT and MCT; and in the former it also stimulates Na-K-ATPase activity. The hypokalemia probably activates H-K-ATPase in both. Hypokalemia is a low level of potassium (K +) in the blood serum. Mildly low levels do not typically cause symptoms. Symptoms may include feeling tired, leg cramps, weakness, and constipation. It increases the risk of an abnormal heart rhythm, which is often too slow, and can cause cardiac arrest. Metabolic alkalosis is a metabolic condition in which the pH of tissue is elevated beyond the normal range (7.35–7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate, or alternatively a direct result of increased bicarbonate concentrations. Excessive intravenous administration of alkali alone will cause a metabolic alkalosis which is only short-lived because of rapid renal excretion of bicarbonate (as mentioned previously).