Metabolic acidosis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD's weight loss doctor NYC
Philadelphia GLP-1 weight loss and GLP-1 clinic NYC

Metabolic acidosis
File:Bicarbonate Levels in Metabolic Acidosis.jpg
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Rapid breathing, confusion, fatigue, headache
Complications	Shock (circulatory), coma, death
Onset	Sudden or gradual
Duration	Variable
Types	N/A
Causes	Diabetic ketoacidosis, lactic acidosis, renal failure, diarrhea
Risks	Diabetes mellitus, chronic kidney disease, alcoholism
Diagnosis	Arterial blood gas, serum electrolytes
Differential diagnosis	Respiratory acidosis, metabolic alkalosis
Prevention	N/A
Treatment	Sodium bicarbonate, intravenous fluids, dialysis
Medication	Bicarbonate, insulin
Prognosis	Depends on underlying cause
Frequency	Common
Deaths	N/A

Metabolic Acidosis

Metabolic acidosis is a condition characterized by an increase in the acidity of the blood due to a disruption in the acid-base balance within the body. It is marked by low levels of bicarbonate (HCO3-) in the body, indicating an excess of acid or an inability to neutralize or excrete acid.

Etiology

Metabolic acidosis can occur due to a wide range of causes: Diabetes Mellitus: Particularly in poorly controlled diabetes, where it leads to ketoacidosis, a condition caused by excess production of ketone bodies, which are acidic. Kidney Failure: The kidneys play a critical role in maintaining the body's acid-base balance by excreting excess hydrogen ions (H+) and reabsorbing bicarbonate. In kidney failure, this function is impaired, leading to the accumulation of acid in the body. Shock: In severe cases of shock, poor blood flow can lead to lactic acidosis, as tissues resort to anaerobic metabolism, leading to the production of lactic acid.

Symptoms

The clinical presentation of metabolic acidosis varies depending on the severity and duration of the condition. Symptoms may include fatigue, rapid breathing (a compensatory mechanism), nausea or vomiting, and confusion. In severe cases, it can lead to shock or death.

Diagnosis

Diagnosis of metabolic acidosis involves measuring serum electrolytes and arterial blood gases, which help to determine the pH and bicarbonate levels in the blood. The anion gap is also calculated to help determine the underlying cause of the acidosis.

Treatment

Treatment of metabolic acidosis primarily involves managing the underlying cause. In some cases, bicarbonate may be administered to help neutralize the acid. Regular monitoring of blood gases and pH is essential to assess the effectiveness of the treatment and the patient's response.