Metabolic acidosis

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

Causes

Metabolic acidosis develops when too much acid is produced in the body. It can also occur when the kidneys cannot remove enough acid from the body. There are several types of metabolic acidosis:

• Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances called ketone bodies (which are acidic) build up during uncontrolled diabetes (usually type 1 diabetes).

  Diabetic ketoacidosis

  Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. It occurs when the body starts breaking down fat at a r...

  

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• Hyperchloremic acidosis is caused by the loss of too much sodium bicarbonate from the body, which can happen with severe diarrhea.
• Kidney disease (uremia, distal renal tubular acidosis or proximal renal tubular acidosis).
• Lactic acidosis.
• Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol.
• Severe dehydration.

  Dehydration

  Dehydration occurs when your body does not have as much water and fluids as it needs. Dehydration can be mild, moderate, or severe, based on how much...

  

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Lactic acidosis results from a buildup of lactic acid. Lactic acid is mainly produced in muscle cells and red blood cells. It forms when the body breaks down carbohydrates to use for energy when oxygen levels are low. It can be caused by:

• Cancer
• Carbon monoxide poisoning
• Drinking too much alcohol
• Exercising vigorously for a very long time
• Liver failure
• Low blood sugar (hypoglycemia)
• Medicines, such as salicylates, metformin, anti-retrovirals
• MELAS (a very rare genetic mitochondrial disorder that affects energy production)
• Prolonged lack of oxygen from shock, heart failure, or severe anemia

  Shock

  Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...

  

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  Heart failure

  Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...

  

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  Anemia

  Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...

  

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• Seizures

  Seizures

  A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...

  

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• Sepsis -- severe illness due to infection with bacteria or other germs
• Severe asthma

Symptoms

Most symptoms are caused by the underlying disease or condition that is causing the metabolic acidosis. Metabolic acidosis itself causes rapid and deep breathing as your body tries to compensate for it. Confusion or lethargy 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

Your health care provider will perform a physical examination and ask about your symptoms.

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

  Urine ketones

  A ketone urine test measures the amount of ketones in the urine.

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• Urine pH

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

Other tests that may be needed to determine the cause of the acidosis include:

• Chest x-ray
• CT abdomen
• Urinalysis
• Urine pH

Treatment

Treatment is aimed at the health problem causing the metabolic 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)

Metabolic acidosis can be dangerous if untreated. Many cases respond well to treatment. 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 and responding promptly if the blood sugar stays above 250 mg/dL for over 12 hours.

Type 1 diabetes

Type 1 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood.

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