Kidneys
Kidneys

Acidosis

Definition:
Acidosis is a condition characterized by excessive acid in the body fluids.

Alternative Names:
Metabolic acidosis

Causes, incidence, and risk factors:

The acid/base status of the body (pH) is regulated by the kidneys and the lungs. Acidosis is caused by an accumulation of acid or a significant loss of bicarbonate. The major categories of acidosis are respiratory acidosis and metabolic acidosis.

The human body is programmed to correct for either respiratory or metabolic acidosis to maintain normal pH. For example, if the acidosis was caused by excessive carbon dioxide (which is an acid) the body will correct the pH by retaining bicarbonate (a base).

Respiratory acidosis develops when there are excessive amounts of carbon dioxide 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 accumulate during uncontrolled diabetes mellitus.

Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body, like in severe diarrhea for example. Lactic acidosis is an accumulation of lactic acid. This can be caused by many conditions, including prolonged lack of oxygen, certain diseases, prolonged exercise, hyperventilation, and medications such as oral medications used to treat diabetes.

Other causes of metabolic acidosis include severe dehydration -- resulting in decreased tissue perfusion (decreased blood flow), diarrhea, kidney disease (see distal renal tubular acidosis and proximal renal tubular acidosis), and other metabolic diseases.

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 causes respond adequately 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. (See the specific types of acidosis.)
Prevention:
Prevention or treatment of the underlying causes may prevent some cases of acidosis.

Review Date: 1/19/2002
Reviewed By: Andrew Koren, M.D., Department of Nephrology, NYU-Mount Sinai Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.
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