Which of the following is the most common acid-base disturbance in patients with cirrhosis and poal hypeension?

- Metabolic alkalosis and hypokalemia are common in patients with cirrhosis because they often have associated secondary hyperaldosteronism (especially those with ascites), diarrhea, and frequent emesis. - Hyperaldosteronism enhances H+ and K+ exchange for Na+ in the distal tubule of the kidney. - The cause of diarrhea in patients with cirrhosis is unknown, but malabsorption secondary to splanchnic venous hypeension may be a contributing factor. - Emesis is common in alcoholic cirrhotics & patients with tense ascites. - Deleterious effects of metabolic alkalosis include impaired tissue oxygen delivery secondary to shift of oxyhemoglobin dissociation curve to the left & conversion of ammonium chloride to ammonia, which may contribute to encephalopathy.