Acid-base and electrolyte abnormalities in alcoholic patients.

This study was undertaken to analyze the acid-base and electrolyte abnormalities and the pathogenetic mechanisms involved in alcoholic patients admitted to our department for causes related to alcohol abuse. We studied 79 alcoholic patients aged 31-78 years. None had any other disease or was receiving drugs influencing acid-base balance and electrolyte parameters. On their admission and before any therapeutic intervention laboratory investigation of the acid-base status and electrolyte parameters in both sera and urine was carried out. Thirty-two patients (40.5%) had acid-base disturbances. Ten patients (12.6%) had pure respiratory alkalosis, 2 patients (2.5%) pure metabolic alkalosis, while 20 patients (25.3%) had the so-called syndrome of alcoholic ketoacidosis. Forty-one patients (52%) had electrolyte abnormalities. Eighteen patients (22.8%) had hyponatremia. However, 5 patients had pseudohyponatremia due to alcohol-induced hypertriglyceridemia. Two patients (2.5%) with increased insensible losses had hypernatremia. Hypokalemia was found in 10 patients (12.6%), hypomagnesemia in 25 patients (31.6%), hypophosphatemia in 23 patients (29.1%), hyperphosphatemia in 2 patients (2.5%), and hypocalcemia in 17 patients (21.5%). However, only 7 patients had true hypocalcemia. In conclusion, alcoholic patients develop a series of acid-base and electrolyte disturbances owing to various pathogenetic mechanisms.