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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.
A.D.A.M. Medical Encyclopedia.
Metabolic acidosis is a condition in which there is too much acid in the body fluids.
Causes, incidence, and risk factors
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
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.
Signs 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.
Expectations (prognosis)
What can be expected will depend on the underlying disease causing the metabolic acidosis.
Complications
When very severe, metabolic acidosis can lead to shock or death.
Calling your health care provider
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.
Review Date: 11/17/2011.
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Buffered versus non‐buffered fluids given to adults during surgery
During surgery, patients are given fluids into their veins to prevent and treat dehydration and loss of blood. Some fluids consist of a simple salt solution whilst others are matched more closely to the fluid in the blood. These latter fluids are called buffered fluids because they maintain the balance of the acids and bases in the body. We searched the available literature for prospective randomized studies which compared outcomes with the use of buffered fluids and the use of non‐buffered fluids when given to patients during surgery.
How we know if a treatment worksTesting Treatments is a lively look at modern clinical research, and how everyone can get involved in using and improving research for better health care.
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