Acidosis

Kidneys
Definition:
Acidosis is excessive acid in the body fluids.
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 maor 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. !or example" if the acidosis #as caused by excessive carbon dioxide
(#hich is an acid) the body #ill correct the pH by retaining bicarbonate (a base).
$espiratory acidosis develops #hen there are excessive amounts of carbon dioxide in the body"
primarily caused by decreased breathing. %ther names for this include hypercapnic acidosis and
carbon dioxide acidosis.
There are several types of metabolic acidosis. &iabetic acidosis (also called diabetic ketoacidosis
and &KA) develops #hen ketone bodies accumulate during uncontrolled diabetes.
Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body" as in
severe diarrhea" for example.
'actic acidosis is an accumulation of lactic acid. This can be caused by many conditions"
including prolonged lack of oxygen (from" for example" shock" heart failure" or severe anemia)"
prolonged exercise" sei(ures" hypoglycemia (lo# blood sugar)" alcohol" liver failure" malignancy"
or certain medications like salicylates.
%ther causes of metabolic acidosis include severe dehydration )) resulting in decreased tissue
perfusion (decreased blood flo#)" kidney disease (see distal renal tubular acidosis and proximal
renal tubular acidosis)" and other metabolic diseases.
Symptoms:
*ee the specific types of acidosis.
Signs and tests:
An arterial blood gas analysis or a blood chemistry" such as a +hem),-" #ill confirm acidosis in
most cases. %ther tests may be needed to determine the cause of the acidosis.
Treatment:
Treatment depends on the cause. *ee the specific types of acidosis.
Expectations (prognosis):
Acidosis can be dangerous if untreated. .any causes respond ade/uately to treatment.
Complications:
*ee the specific types of acidosis.
Calling your health care proider:
Although there are several types of acidosis" all #ill cause symptoms that re/uire treatment by
your health care provider. (*ee the specific types of acidosis.)
!reention:
0revention or treatment of the underlying causes may prevent some cases of acidosis.
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$evie#ed 5y1 +olm +. .agee" .&" .0H" .edical &irector" $enal Transplant" 5righam 6
7omen8s Hospital" and Assistant 0rofessor" Harvard .edical *chool" 5oston" .A. $evie#
provided by 9eri.ed Healthcare :et#ork.