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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, or when the kidneys are not removing enough acid from the body.

    There are several types of metabolic acidosis:

    • Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances known as ketone bodies, which are acidic, build up during uncontrolled type 1 diabetes
    • Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body, as can happen with severe diarrhea
    • Lactic acidosis is a buildup of lactic acid. It can be caused by:
      • Alcohol
      • Cancer
      • Exercising for a very long time
      • Liver failure
      • Low blood sugar (hypoglycemia)
      • Medications such as salicylates
      • Prolonged lack of oxygen from shock, heart failure, or severe anemia
      • Seizures

    Other causes of metabolic acidosis include:

    • Kidney disease (distal 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 usually causes rapid breathing. Confusion or lethargy may also occur. Severe metabolic acidosis can lead to shock or death. In some situations, metabolic acidosis can be a mild, chronic (ongoing) condition.

    Exams and Tests

    • Arterial blood gas
    • Serum electrolytes
    • Urine pH

    Arterial blood gas analysis or a serum electrolytes test (such as a basic metabolic panel) will confirm acidosis is present and determine whether it is respiratory acidosis or metabolic acidosis.

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

    Treatment

    Treatment is aimed at the underlying condition. In certain circumstances, sodium bicarbonate (baking soda) may be given to improve the acidity of the blood.

    Outlook (Prognosis)

    What can be expected will depend on the underlying disease causing the metabolic acidosis.

    Possible Complications

    When very severe, metabolic acidosis can lead to shock or death.

    When to Contact a Medical Professional

    Seek medical treatment if you develop symptoms of any disease that can cause metabolic acidosis.

    Prevention

    Keeping type 1 diabetes under control may help prevent diabetic ketoacidosis, one type of metabolic acidosis.

    References

    Seifter JL. Acid-base disorders.In: Goldman L, Schafer AI, eds.Cecil Medicine. 24th ed.Philadelphia,PA: Saunders Elsevier; 2011:chap 120.

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          Tests for Metabolic acidosis

            Review Date: 11/17/2011

            Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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