The most common causes of metabolic alkalosis are Diuretic use Volume depletion (particularly when involving loss of gastric acid and chloride [Cl] due to recurrent vomiting or nasogastric suction) Among other causes of metabolic alkalosis are disorders that cause Bicarbonate excess Renal acid loss Table Metabolic alkalosis can be Chloride (Cl) - responsive: Involves loss or excess secretion of Cl; it typically corrects with IV administration of NaCl-containing fluid.