Diuretic abuse can lead to numerous electrolyte imbalances and dangerous metabolic alkalosis, although some complications can be avoided with the use of diuretics that do not affect potassium, such as spironolactone, in replacement of other diuretics. Sodium chloride is lost in urine, causing intravascular volume depletion which in turn leads to elevated aldosterone levels. High serum aldosterone then causes hydrogen and potassium to be excreted via urination, which can lead to metabolic alkalosis.