Causes And Treatment Of Metabolic Acidosis

Metabolic acidosis causes a reduction in the body’s bicarbonate concentration. Therefore, it makes the pH level in the blood more acidic. Furthermore, this reduction leads to a compensatory decrease in the partial pressure of carbon dioxide. Basically, there is a discrepancy in the acid-base balance, which means that there is too much acid in the blood.

There are several degrees of severity, some of which can be fatal.

The causes of metabolic acidosis

The occurrence of metabolic acidosis is usually caused by more than one mechanism at a time, such as:

• Excessive intake or excessive endogenous production of non-volatile acids. For example, this may be caused by both diabetic ketoacidosis, lactic acidosis and acidosis caused by ingestion of an acid precursor.
• Changes in renal bicarbonate regeneration (acidosis in chronic or acute renal failure ) or decreased proton secretion in the middle piece (distal tubulus) (distal renal tubular acidosis).
• Loss of alkaline substances. Usually, this loss can occur in the kidneys or digestive tract.

The symptoms of metabolic acidosis

The symptoms of metabolic acidosis are not specific. Precisely because of this, this condition can be difficult to diagnose. However, if the patient has clear indications that the doctor is requesting an arterial blood gas test, it is easier.

The symptoms that these patients suffer from include the following:

• Chest pain
• Palpitations
• Headache
• Changed mental status. All in all, this includes severe anxiety, impaired vision and nausea. Vomiting, abdominal pain, changes in appetite and weight loss may also occur.
• Finally, those suffering from metabolic acidosis often manifest so-called “Kussmaul respiration”. This type of breathing is deep and rapid and often accompanies diabetic ketoacidosis.

Furthermore, extreme acidosis can lead to neurological and cardiac complications :

• Neurological complications. This includes lethargy, lethargy, coma and seizures.
• Heart complications. Arrhythmias and decreased epinephrine response may occur. In addition, both situations lead to hypotension (abnormally low blood pressure).

• Severe metabolic acidosis can lead to shock or death.

Diagnosis

Certain tests may help diagnose metabolic acidosis. They can also help determine if the cause is a respiratory condition or a metabolic problem.

The tests usually include:

• Arterial blood gas sample.
• A comprehensive metabolic panel. These are a series of blood tests that measure the sodium and potassium levels in the blood, kidney function and other chemicals and functions.
• The pH level in urine.
• Urine and blood ketones.
• Lactic acid sample.

Treatment of metabolic acidosis

First and foremost, medical professionals must prescribe a treatment for what triggers the disorder. Patients with renal failure need hemodialysis. Sometimes doctors also use this in people with ethylene glycol, methanol and salicylate poisoning.

Then, in cases of severe acidosis, doctors usually administer sodium bicarbonate. However, they must do this with caution. This is because it is harmful under certain circumstances.

All in all, the bicarbonate treatment is generally safe and appropriate. However, when the acidosis is due to an accumulation of organic acids, this treatment is controversial. This is because it does not significantly reduce mortality under these conditions. In addition, it can carry certain risks.

Despite these and other controversies, most experts still recommend that in severe metabolic acidosis, bicarbonate is administered intravenously, causing pH levels below 7.1.