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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia [Internet].

Metabolic acidosis

Acidosis - metabolic

Last reviewed: October 29, 2013.

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:

Other causes of metabolic acidosis include:

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 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

  1. 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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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

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. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • There is limited evidence from three small trials suggesting that the correction of metabolic acidosis trials may have some beneficial effects on both protein and bone metabolismThere is limited evidence from three small trials suggesting that the correction of metabolic acidosis trials may have some beneficial effects on both protein and bone metabolism
    In health, protein and amino acids remain in equilibrium however in CKD this balance is disturbed. Metabolic acidosis has been shown to have deleterious effects on protein balance, leading to a negative nitrogen balance, increased protein degradation, increased essential amino acid oxidation, reduced albumin synthesis and a lack of adaption to a low protein diet, and hence is associated with protein energy malnutrition, loss of lean body mass and muscle weakness. Metabolic acidosis is also a factor in the development of renal bone disease, as bone acts as a buffer for excess acid, with loss of mineral resulting from the increase in acid. This review found three small trials in adult haemodialysis patients (n = 117). The evidence for the benefits and risks of correcting metabolic acidosis is very limited with no RCTs in pre‐ESRD patients and none in children. These trials suggest there may be some beneficial effects on both protein and bone metabolism but the trials were underpowered to provide strong evidence.
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