Acidosis

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Introduction

What is acidosis?

Acidosis is a serious metabolic imbalance in which there is an excess of acidic molecules in the body. This can occur as a result of acid overproduction, impaired acid transport, acid underexcretion, or any combination. With overproduction, the body makes too much acid. This can occur in sepsis, a life-threatening widespread infection in which the body makes too much lactic acid. With underexcretion, the body is unable to rid itself of excess acid. This can occur in renal failure and various lung diseases.

In renal failure, the kidneys are unable to cleanse the blood of acid. In pulmonary diseases, the lungs are unable to exhale sufficient carbon dioxide. Carbon dioxide is a gaseous form of acid that builds up in the bloodstream. Both conditions may coexst in a number of serious diseases, such as pneumonia and pulmonary edema (fluid in the lungs), which is seen in a particularly severe form of heart failure.

Doctors diagnose acidosis with blood tests, the most common of which is known as a pH test. The normal pH of the body is 7.4 (a lower pH value is more acidic, higher pH is more alkaline). Acidosis is defined as a pH less than 7.4. Specific blood tests may be used to identify particular acids, such as lactic acid.

The treatment of acidosis depends on its cause. Therapy may range from simple interventions, such as oral medications and intravenous fluids, to invasive measures, such as dialysis and surgery. The outcome of acidosis depends on its severity.

Seek immediate medical care (call 911) for serious symptoms, such as rapid breathing, confusion, shortness of breath, and lethargy, especially in the setting of lung disease, kidney disease, or other diseases that can cause acidosis.

Seek prompt medical care if you are being treated for chronic acidosis but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of acidosis?

Symptoms of acidosis include your body attempting to decrease its level of acid, such as through rapid breathing. Other symptoms will depend on the underlying cause of acidosis.

Common symptoms of acidosis

Acidosis symptoms vary widely depending on the underlying cause. A variety of illnesses that cause acidosis do share some common symptoms including:

Serious symptoms that might indicate a life-threatening condition

In many cases, acidosis can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms in the setting of an underlying cause of acidosis:

Causes

What causes acidosis?

Acidosis is caused by an accumulation of acid in your body. Normally, your body effectively excretes or neutralizes acid through normal breathing and kidney function. If these functions are perturbed, or if the amount of acid your body produces increases significantly, acidosis can result.

A wide variety of conditions can cause or contribute to acidosis. They are generally broken down into groups known as metabolic acidosis or respiratory acidosis.

Common causes of metabolic acidosis

Metabolic acidosis occurs when your body generates excess acid, fails to remove or break down acid, or both such as occurs with:

Common causes of respiratory acidosis

Respiratory acidosis occurs when you have a lung defect or your breathing patterns result in too much carbon dioxide in your body:

What are the risk factors for acidosis?

A number of factors increase the risk of developing acidosis. Not all people with risk factors will get acidosis. Risk factors for acidosis include:

  • Asthma

  • Chronic obstructive pulmonary disease (COPD, includes emphysema and chronic bronchitis), especially when severe, as it can limit lung function and cause acidosis

  • Diabetes, especially when untreated, can significantly increase the risk of acidosis

  • Kidney disease

  • Obesity

  • Severe diarrhea

Treatments

How is acidosis treated?

Treatment for acidosis depends on the underlying cause. Treatments for respiratory acidosis target the lungs to improve efficiency so you can exhale carbon dioxide more effectively. Treatment for metabolic acidosis targets the underlying cause, though agents that decrease acidity may be given.

Treatment of respiratory acidosis

Treatment for respiratory acidosis may include:

  • Bronchodilators may be used if airway disease is causing decreased breathing efficiency

  • Mechanical ventilation or positive pressure breathing devices may be used

  • Oxygen may be given

Treatment of metabolic acidosis

Sodium bicarbonate may be given to decrease blood acid levels.

What are the potential complications of acidosis?

Acidosis is a serious medical condition that is often life threatening when severe. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of acidosis include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 4
  1. Respiratory acidosis. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000092.htm.
  2. Metabolic acidosis. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000335.htm.
  3. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
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