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A 23-year-old dancer is referred for fatigue and leg cramps. Her blood pressure is 104/68 mm Hg, and she denies vomiting and any diuretic or laxative use. Results: sodium 137, potassium 2.7, chloride 89 and total CO2 36 mmol/L; magnesium normal. Arterial pH 7.49, pCO2 47 mm Hg [6.3 kPa], HCO3- 35 mmol/L. Spot urine: sodium 52 mmol/L, potassium 38 mmol/L, chloride 6 mmol/L, pH 7.5. A urine diuretic screen is negative on two separate samples, and plasma renin and aldosterone are both raised. The most likely cause of her metabolic alkalosis is:
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