Why is bicarbonate elevated in Pyloric stenosis?
I've always memorized the "hypochloremic, hypokalemic, metabolic alkalosis" line. I completely understand all of it except for why bicarb is high. I initially figured it should be low if the body's trying to compensate.
I read somewhere that the loss of chloride leads to low serum chloride, which impairs the kidney's ability to excrete bicarbonate, resulting in an inability to correct the metabolic alkalosis. But those places don't explain exactly why chloride is necessary to excrete bicarb?
I was thinking it might have something to do with the fact that the kidney uses Cl- as buffers for Na, K, and NH4 to allow excretion of those anions, but I still can't grasp the idea.
Any help, please?