Chloride Metabolism and Alkalosis in Alkali Treatment of Peptic Ulcer

Wildman, H. A.

doi:10.1001/archinte.1929.00130280046003

Cited by 12 publications

(1 citation statement)

References 25 publications

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“…20,26,27,36 However, it is widely recognized that MAS can develop without renal impairment. 37 Furthermore, even in patients with impaired renal function, large amounts of absorbable alkali do not lead to alkalosis in most individuals. 14,38,39 Some authors found no preexisting kidney disease in most of their patients with MAS.…”

Section: Incidencementioning

confidence: 99%

Milk-Alkali Syndrome

Medarov

2009

Mayo Clinic Proceedings

108

113

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Milk-alkali syndrome (MAS) consists of hypercalcemia, various degrees of renal failure, and metabolic alkalosis due to ingestion of large amounts of calcium and absorbable alkali. This syndrome was first identified after medical treatment of peptic ulcer disease with milk and alkali was widely adopted at the beginning of the 20th century. With the introduction of histamine2 blockers and proton pump inhibitors, the occurrence of MAS became rare; however, a resurgence of MAS has been witnessed because of the wide availability and increasing use of calcium carbonate, mostly for osteoporosis prevention. The aim of this review was to determine the incidence, pathogenesis, histologic findings, diagnosis, and clinical course of MAS. A MEDLINE search was performed with the keyword milk-alkali syndrome using the PubMed search engine. All relevant English language articles were reviewed. The exact pathomechanism of MAS remains uncertain, but a unique interplay between hypercalcemia and alkalosis in the kidneys seems to lead to a self-reinforcing cycle, resulting in the clinical picture of MAS. Treatment is supportive and involves hydration and withdrawal of the offending agents. Physicians and the public need to be aware of the potential adverse effects of ingesting excessive amounts of calcium carbonate.

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