Mechanism of Paradoxical Acidurea

by admin on September 10, 2010

Paradoxical acidurea is seen in congenital hypertrophy of pylorus. Due to hypertrophy of pylorus, food can not pass from stomach to below, so due to distention of abdomen, vomiting happens, this vomitus does not contain bile ultimately leading to electrolyte imbalances, let me explain you how?

Since child will loose acid and chloride via vomiting, a hypochloromic alkalosis will develop in body, which will cause urine to become alkaline. Urine remains in alkaline form for 3-4 days and after that it becomes acidic, this is known as paradoxical acidurea or paradoxical acidity of urine. What is the reason for it?

Reason is that since body was in alkalosis, so body was trying to restore, or collect hydrogen ion from body, for which sodium ion was released outside causing hyponatremia. This hyponatremia caused aldosterone secretion so as to reabsorb the sodium which will take place only by excreting hydrogen ion and potassium ion in urine and child will develop hyponatremic hypokalemic alkalosis.


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