Metabolic acidosis

 

Alternative Names

Acidosis - metabolic

Definition

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 acidic substances known as ketone bodies, build up in the body. This occurs with uncontrolled type 1 diabetes

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
  • 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 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 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 and 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 some cases, sodium bicarbonate (the chemical in baking soda) may be given to reduce the acidity of the blood.

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

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

Review Date: 10/29/2013
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, Bethanne Black, and the A.D.A.M. Editorial team.

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