Metabolic Acidosis
Metabolic acidosis is a state of excess acid in body fluids, usually from increased acid production, loss of bicarbonate, or impaired acid excretion. It is a sign of an underlying problem requiring evaluation.
Table of Contents
Quick Facts
- ICD-10: E87.2
- Common in: Diabetes (DKA), severe illness
Often an Emergency
Severe metabolic acidosis is a medical emergency. Symptoms requiring 911: rapid deep breathing, confusion, severe weakness, fruity breath in someone with diabetes (DKA).
Symptoms
- Rapid, deep breathing (Kussmaul respirations)
- Confusion or drowsiness
- Headache
- Fatigue, weakness
- Nausea, vomiting
- Loss of appetite
Common Causes
- Diabetic ketoacidosis
- Severe diarrhea (bicarbonate loss)
- Kidney failure
- Lactic acidosis (sepsis, shock, severe exercise, some medications)
- Poisoning (methanol, ethylene glycol, aspirin)
- Renal tubular acidosis
Diagnosis
- Arterial blood gas
- Comprehensive metabolic panel
- Anion gap calculation
- Lactate, ketones
- Tests directed at suspected cause
Treatment
- Treat the underlying cause (insulin for DKA, fluids for dehydration, antibiotics for sepsis)
- Bicarbonate replacement in selected cases
- Dialysis for severe cases or specific toxins
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.
References
- American Society of Nephrology. Acid-Base Disorders Resources.