Fig. 5.

The abnormal NaCl reabsorption in thick ascending loop of Henle results in increased delivery of NaCl to distal nephron. In an attempt to reabsorb sodium, potassium and hydrogen ions are lost leading to metabolic alkalosis and hypokalemia. Also excessive loss of salt and water causes activation of RAAS (Renin-angiotensin-aldosterone system) which help maintain normotension, causes counter-regulatory increase of vasodilatory PGE2, and aggravates metabolic alkalosis and hypokalemia. Defective paracellular reabsorption of calcium and magnesium leads to hypocalcemia and hypomagnesemia