Introduction

Physiologically, body fluids usually have their pH regulated and kept between a range of 7.35-7.45. Metabolic acidosis is an acid-base disorder characterized by acidemia-  pH is kept below the lower normal limit of 7.35. This happens when there is a build up of acids within the body fluids.

This condition is not contagious and therefore cannot be spread form one affected individual to another unaffected person.

 

 Key Facts & Statistics

What are the key facts and statistics about metabolic acidosis?

• Acute metabolic acidosis has an incidence that ranges between 14% and 42%. it mostly occurs during critical illnesses.
• Patients with chronic kidney disease have a high prevalence of metabolic acidosis.
• Several forms of metabolic acidosis exist, and these are:

1. Lactic acidosis.
2. Hyperchloremic metabolic acidosis.
3. Diabetic ketoacidosis.

 

Types

What are the most common types of metabolic acidosis?

• Diabetes-related acidosis.
• Hyperchloremic acidosis.
• Lactic acidosis.
• Renal tubular acidosis.

 

 Causes

What are the causes of metabolic acidosis?

Metabolic acidosis occurs due:

• Increased production of acids.
• Bicarbonate loss.
• Reduced ability of kidneys to excrete excess acids.

 

Diabetes-related acidosis

• Ketone bodies are used by the body to produce energy when there is insufficient availability of glucose.
• This type of metabolic acidosis develops due to accumulation of ketones as a complication of untreated or uncontrolled diabetes (usually type 1).

 

Hyperchloremic acidosis

• It occurs due to excessive loss of sodium bicarbonate through situations such as severe diarrhea.

 

Lactic acidosis

• As the name sounds, lactic acidosis occurs due to lactic acid accumulating in the body tissues. This organic acid is produced during anaerobic respiration.
• It can be caused by;

1. Hypogylemia.
2. Extreme physical activities such as intense running.
3. Liver failure.
4. Alcohol use disorder.
5. Cancer.
6. Sepsis.
7. Medications such as salicylates and metformin.
8. Carbon monoxide poisoning.

 

Renal tubular acidosis

• It happens when the kidneys are unable to secrete adequate acids into urine, leading to acidemia.

 

 Signs & Symptoms

What are the signs and symptoms of metabolic acidosis?

• Rapid heart rate (tachycardia).
• Fatigue.

• Rapid respiratory rate, associated with deep breathing.
• Nausea.
• Vomiting.
• Weakness.
• Pleasant, fruity breath.
• Dizziness.
• Loss of appetite.
• Death, in severe cases.

 

 Diagnostic Procedures & Tests

How is metabolic acidosis diagnosed?

Diagnosis involves steps such as:

• Review of patient’s symptoms and medical history.
• Performance of a physical examination.
• Tests;

1. Blood tests for anion gap analysis and arterial blood gas analysis.
2. Urine tests. Urinalysis can be conducted to check for urine pH and presence of ketones.

 

 Treatment and Management

How is metabolic acidosis treated?

Metabolic acidosis is treated according to its cause. Some treatment strategies include:

• Administration of sodium citrate to patients with kidney disease.
• Intravenous administration of fluids. IV sodium bicarbonate to balance acidic content is also given.
• Insulin for diabetes-related acidosis.
• Detoxification of the body by removing toxic compounds from blood such as acetyl salicylic acid and methanol.

 

 Complications

What are the complications of metabolic acidosis?

The following complications can occur as a result of very severe metabolic acidosis:

• Shock.
• Death.

 

Prevention

How do we prevent metabolic acidosis?

There are several strategies that can be embraced to lower your risk of developing metabolic acidosis. These include:

• Drinking lots of water and other fluids.
• Diabetic patients should frequently check their blood sugar levels to keep them not fairly high.
• Alcoholic individuals are advised to consume moderate amounts of alcoholic beverages.
• Treat diabetes type 1 to prevent developing diabetic ketoacidosis (DKA).