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Metabolic Acidosis

Decreased plasma bicarbonate and blood pH falling below 7.35.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Metabolic Acidosis?

Metabolic acidosis is an acid-base disorder defined by a decrease in plasma bicarbonate level and a fall in blood pH below 7.35. The main classification is according to the 'anion gap': high anion gap (lactic acidosis, diabetic ketoacidosis, uremic, toxins) and normal anion gap (diarrhea, renal tubular acidosis).

While excess acid accumulation in the body is the issue in high anion gap acidosis, bicarbonate loss (compensation with hyperchloremia) is prominent in normal anion gap acidosis. The mnemonics MUDPILES and GOLDMARK are used in differential diagnosis.

Treatment is directed at etiology; bicarbonate replacement is recommended only in specific indications (severe acidosis, renal failure, toxicity).

Symptoms

Kussmaul respiration (deep and rapid breathing)
Nausea, vomiting, and loss of appetite
Fatigue and weakness
Confusion and lethargy
Abdominal pain and headache
Symptoms of hyperkalemia (cardiac arrhythmia)
Coma and shock in severe cases

Risk Factors

Diabetic ketoacidosis
Renal failure (uremic acidosis)
Septic shock and lactic acidosis
Chronic diarrhea
Methanol, ethylene glycol, salicylate poisoning
Renal tubular acidosis
Metformin use (rarely lactic acidosis)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If Kussmaul respiration and confusion are present (urgent)
  • If there is high blood sugar and vomiting in diabetes
  • Deterioration in chronic kidney failure patient
  • Severe sepsis or shock picture
  • Suspicion of toxic substance ingestion

Treatment Methods

01
Specific treatment directed at etiology (insulin in DKA, antibiotics in sepsis)
02
Fluid resuscitation and hemodynamic stabilization
03
IV sodium bicarbonate in severe acidosis (pH <7.1)
04
Oral sodium bicarbonate or hemodialysis in uremic acidosis
05
Fomepizole and dialysis in toxic alcohol poisonings
06
Monitoring of electrolyte balance

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.