i. Chloride-responsive vs. Non-chloride responsive a. Urinary Cl- < 20 mEq/l means chloride-responsive, which will respond to NaCl. Most alkaloses are in this category and are associated with normal or low blood volumes. 1. Gastric fluid loss 2. Diuretics 3. Posthypercapnic 4. Diarrheal losses of Cl- (congenital or villous adenoma) b. Urinary Cl- > 20 mEq/l means not chloride-responsive. These alkaloses are rare, and are associated with normal to increased plasma volume. The problem is volume expansion secondary to hyperaldo., severe  K+, or severe  Cl-, + leading to HCO3- loss; give plenty of K+, treat with large doses of Aldactone (spironolactone) to inhibit the aldo effect. 1. Conn's disease (primary hyperaldo) 2. Cushing's syndrome (cortisol has some mineralocorticoid effect) 3. Congenital adrenal hyperplasia 4. Bartter's syndrome (congenital hypertrophy of JGA with  renin and inability to reabsorb Cl-) 5. true licorice ingestion (glycyrrhizic acid is similar to aldo) 6. ? profound K+ depletion with  GFR c. Unclassified 1. alkali administration 2. milk-alkali syndrome 3. glucose ingestion after starvation (unknown mechanism) 4. blood transfusion (citrate) 5. large doses of penicillin or carbenicillin (cause increased excretion of K+ and H+ due to large filtered load of - ions)