Metabolic acidosis is a condition which features with increased production of acid or, in case that the kidneys do not function properly and cannot eliminate the excess of acid from the body, increased accumulation of acid. The consequence of this medical condition can be fatal and it requires prompt treatment. The acidosis is actually a consequence of some other underlying medical condition and once it has been brought under control the doctor will find the primary diseases and treat this disease as well.
Symptoms and Signs of Acidosis
Symptoms of this condition are not so specific. Still majority of patients do complain about nausea and vomiting, chest pain, irregular heart beat, headaches. The pain in abdomen and changes in appetite may occur as well. If acidosis progresses the patient develops specific form of breathing called Kussmaul respirations. Kussmaul respirations are typical for diabetic ketoacidosis. This type of breathing tends to reduce the amount of carbon dioxide in the blood. If left untreated even more severe symptoms such as lethargy, stupor and coma can occur. Cardiac symptoms are ventricular tachycardia and hypotension.
Causes of Acidosis
The first cause is connected to inability of the body to excrete the dietary H+ load. This type of acidosis is characteristic for renal failure, hypoaldosteronism and diminished H+ secretion.
Secondary, acidosis can occur due to enhanced H+ load. This type of acidosis includes lactic acidosis, ketoacidosis and acidosis caused by indigestion. Lactic acidosis can be a consequence of circulatory failure, usage of certain medications and due to some toxins. It can be also connected to hereditary diseases. Ketoacidosis occurs in diabetes, chronic alcoholism and in case of undernourishment.
Loss of gastrointestinal HCO3 is another cause of acidosis. Some gastrointestinal conditions which feature with prolonged diarrhea reduce the level of HCO3 and lead to acidosis. Furthermore, some other diseases such as pancreatitis, diseases of biliary tract or intestinal fistulas can also result in acidosis. The loss of HCO3 can be additionally caused by certain medications including cholestyramine and can occur due to ureterosigmoidostomy.
Even if the patient is suffering from certain conditions which lead to renal loss of HCO3 he/ she may develop acidosis.
Treatment of Acidosis
The goal of the treatment is to raise the systemic pH above 7.1 pr 7.2. This way the heart will response better to catecholamines.
The doctor either treats the underlying condition or administers bicarbonate. Still the treatment with bicarbonate is only justified in severe cases of acidosis. Bicarbonates can be effective in hyperchloremic acidosis. While administrating bicarbonates the doctor has to be very cautious. They can cause some serious side effects including volume overload, loss of potassium, acidosis of central nervous system, hypercapnia, and many more.