Acid-base disorders are a major problem in the management of patients with end-stage renal disease. They mainly presented metabolic acidosis with an increased anion gap, however, other acid-base disorders are not excluded. Two hemodialyzed patients are presented who developed severe metabolic alkalosis, the first due to vomiting, which was occasionally exacerbated by respiratory alkalosis due to anxiety neurosis, and the second due to soda intake (prescription given ten years ago when she was in the pre-end stage of chronic kidney failure).