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Metabolic acidosis

Acidosis - metabolic

 

Metabolic acidosis is a condition in which there is too much acid in the body fluids.

Causes

 

Metabolic acidosis occurs when the body produces too much acid. It can also occur when the kidneys are not removing enough acid from the body.

There are several types of metabolic acidosis.

Diabetic acidosis develops when acidic substances, known as ketone bodies, build up in the body. This most often occurs with uncontrolled type 1 diabetes. It is also called diabetic ketoacidosis and DKA.

Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body. This can occur with severe diarrhea.

Lactic acidosis results from a buildup of lactic acid. It can be caused by:

  • Alcohol
  • Cancer
  • Exercising intensely
  • Liver failure
  • Medicines, such as salicylates
  • Prolonged lack of oxygen from shock , heart failure , or severe anemia
  • Seizures

Other causes of metabolic acidosis include:

  • Kidney disease (distal renal tubular acidosis and proximal renal tubular acidosis)
  • Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol
  • Severe dehydration

 

Symptoms

 

Most symptoms are caused by the underlying disease or condition that is causing the metabolic acidosis. Metabolic acidosis itself most often causes rapid breathing. Acting confused or very tired may also occur. Severe metabolic acidosis can lead to shock or death. In some situations, metabolic acidosis can be a mild, ongoing (chronic) condition.

 

Exams and Tests

 

These tests can help diagnose acidosis. They can also determine whether the cause is a breathing problem or a metabolic problem. Tests may include:

  • Arterial blood gas
  • Basic metabolic panel, (a group of blood tests that measure your sodium and potassium levels, kidney function, and other chemicals and functions)
  • Urine pH
  • Urine ketones or blood ketones
  • Lactic acid test
  • Arterial blood gas analysis

Other tests may be needed to determine the cause of the acidosis.

 

Treatment

 

Treatment is aimed at the health problem causing the acidosis. In some cases, sodium bicarbonate (the chemical in baking soda) may be given to reduce the acidity of the blood. Often, you will receive lots of fluids through your vein.

 

Outlook (Prognosis)

 

The outlook will depend on the underlying disease causing the condition.

 

Possible Complications

 

Very severe metabolic acidosis can lead to shock or death.

 

When to Contact a Medical Professional

 

Seek medical help if you have symptoms of any disease that can cause metabolic acidosis.

 

Prevention

 

Diabetic ketoacidosis can be prevented by keeping type 1 diabetes under control.

 

 

References

Krapf R, Seldin DW, Alpern RJ. Clinical syndromes of metabolic acidosis. In: Alpern RJl, Orson WM, Caplan M, eds. Seldin and Giebisch's The Kidney . 5th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 59.

Seifter JL. Acid-base disorders In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 118.

 
  • Insulin production and diabetes - illustration

    Insulin is a hormone produced by the pancreas that is necessary for cells to be able to use blood sugar.

    Insulin production and diabetes

    illustration

    • Insulin production and diabetes - illustration

      Insulin is a hormone produced by the pancreas that is necessary for cells to be able to use blood sugar.

      Insulin production and diabetes

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Metabolic acidosis

           

             

            Review Date: 11/1/2015

            Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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