What is the definition of Metabolic Acidosis?

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

What are the alternative names for Metabolic Acidosis?

Acidosis - metabolic

What are the causes for Metabolic Acidosis?

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.
  • 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.

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
  • Seizures

What are the symptoms for Metabolic Acidosis?

Most symptoms are caused by the underlying disease or condition that is causing the metabolic acidosis. Metabolic acidosis itself most often causes rapid breathing. Acting confused or very tired may also occur. Severe metabolic acidosis can lead to shock or death. In some situations, metabolic acidosis can be a mild, ongoing (chronic) condition.

What are the current treatments for Metabolic Acidosis?

Treatment is aimed at the health problem causing the 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.

What is the outlook (prognosis) for Metabolic Acidosis?

The outlook will depend on the underlying disease causing the condition.

What are the possible complications for Metabolic Acidosis?

Very severe metabolic acidosis can lead to shock or death.

When should I contact a medical professional for Metabolic Acidosis?

Seek medical help if you have symptoms of any disease that can cause metabolic acidosis.

How do I prevent Metabolic Acidosis?

Diabetic ketoacidosis can be prevented by keeping type 1 diabetes under control.

Insulin production and diabetes

REFERENCES

Hamm LL, DuBose TD. Disorders of acid-base balance. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 16.

Palmer BF. Metabolic acidosis. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 12.

Seifter JL. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 110.