Acidosis

Definition

Acidosis is excessive acid in the body fluids.

Causes, incidence, and risk factors

The kidneys and lungs maintain the body's acid/base (pH) balance. Acidosis occurs when acid builds up or bicarbonate (a base) is lost. The major categories of acidosis are respiratory acidosis and metabolic acidosis.

Respiratory acidosis develops when there is too much carbon dioxide (an acid) in the body, primarily caused by decreased breathing. Other names for this include hypercapnic acidosis and carbon dioxide acidosis.

There are several types of metabolic acidosis:

• Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when ketone bodies build up during uncontrolled diabetes.
• Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body, as in severe diarrhea.
• Lactic acidosis is a buildup of lactic acid. This can be caused by:
  • Alcohol
  • Cancer
  • Liver failure
  • Low blood sugar (hypoglycemia)
  • Medications such as salicylates
  • Prolonged exercise
  • Prolonged lack of oxygen from shock, heart failure, or severe anemia
  • Seizures

Other causes of metabolic acidosis include:

• Kidney disease (distal renal tubular acidosis and proximal renal tubular acidosis)
• Severe dehydration

Symptoms

See the specific types of acidosis.

Signs and tests

An arterial blood gas analysis or a blood chemistry, such as a Chem-20, will confirm acidosis in most cases. Other tests may be needed to determine the cause of the acidosis.

Treatment

Treatment depends on the cause. See the specific types of acidosis.

Expectations (prognosis)

Acidosis can be dangerous if untreated. Many cases respond well to treatment.

Complications

See the specific types of acidosis.

Calling your health care provider

Although there are several types of acidosis, all will cause symptoms that require treatment by your health care provider.

Prevention

Preventing or treating the underlying causes may prevent some cases of acidosis.