Metabolic acidosis is a condition in which acids build up in your body. Causes include untreated diabetes, the loss of bicarbonate in your body and kidney conditions. Symptoms include an accelerated heartbeat, confusion and fatigue. Blood and urine tests can help diagnose it. Treatment may include sodium bicarbonate, IV fluids and insulin.
Metabolic acidosis is when acids build up in your body fluids.
Metabolic acidosis can develop if you have too many acids in your blood that wipe out bicarbonate (high anion gap metabolic acidosis) or if you lose too much bicarbonate in your blood as a result of kidney disease or kidney failure (normal anion gap metabolic acidosis).
Bicarbonate is a base. It’s a form of carbon dioxide — a waste byproduct after your body converts food to energy.
An anion gap is the difference between the positive and negative electric charges in the electrolytes in your blood. Electrolytes are ions that help regulate many metabolic processes in your body, such as bringing nutrients into your cells and taking waste products out of your cells. Examples of electrolytes include sodium, calcium, potassium, chloride and phosphate.
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Metabolic acidosis can affect anyone. However, it commonly affects people who have kidney failure (renal failure) or chronic (long-lasting) kidney disease.
Your body must have a specific pH balance to function properly. The pH scale is the levels of acids and bases in your blood. The pH scale ranges from 0 (very acidic) to 14 (very basic or alkaline). A normal pH range in your blood is from 7.35 to 7.45.
Your kidneys and lungs help maintain a proper pH balance. Your kidneys remove excess acids and bases from your blood through your urine (pee). Your lungs regulate the amount of carbon dioxide in your blood.
Metabolic acidosis occurs when your body produces too much acid, or your kidneys don’t remove enough acids from your blood.
If you have metabolic acidosis, there may not be any signs or symptoms.
Common signs and symptoms of metabolic acidosis include:
Severe cases of metabolic acidosis can cause death.
The four leading causes of metabolic acidosis include:
Unmanageable diarrhea and kidney failure are the most common causes of metabolic acidosis.
No, metabolic acidosis isn’t contagious. You can’t spread metabolic acidosis to another person.
Your healthcare provider will ask you about your symptoms and may perform a physical examination. They’ll also order tests to help confirm their diagnosis. They may also refer you to a nephrologist. A nephrologist is a doctor who specializes in kidney diseases.
Your healthcare provider may order different tests according to what they believe may be the cause of your metabolic acidosis. These tests may include:
Blood tests help provide important information about chemicals in your blood. Blood tests for metabolic acidosis may include:
During a urine test, you’ll pee into a special cup. Your healthcare provider will check the pH level of your pee. You may have too many acids in your pee or not enough bases in your pee.
Once your healthcare provider determines what’s causing metabolic acidosis, they can recommend an appropriate treatment plan. Some treatments include:
Certain foods and drinks can cause your body to make more acids. Before making any changes to your diet, talk to your healthcare provider. They can guide you on safely incorporating or increasing the right foods or drinks in your diet. They may also refer you to a dietitian who specializes in kidney diseases (renal dietitian).
Foods and drinks that cause your body to make acids include:
Foods or drinks that produce alkali include:
The over-the-counter (OTC) medications sodium citrate or sodium bicarbonate can help balance the acids in your body. Talk to your healthcare provider before taking any OTC medications to help treat your metabolic acidosis.
Your healthcare provider may also prescribe inotropes. Inotropes help your heart beat stronger, which helps get more oxygen in your body and lowers the amount of acids in your blood. Your healthcare provider can deliver inotropes to your body through an IV in a vein in your arm.
You can’t prevent metabolic acidosis. However, you can help reduce your risk by:
If you have metabolic acidosis, your outlook depends on its severity and what’s causing the condition.
Many cases of metabolic acidosis respond well to treatment after a proper diagnosis.
In mild cases, your symptoms may be temporary, and you may not need treatment.
Severe cases may involve kidney or other organ failure and death.
Your healthcare provider will work with you to develop a treatment plan, which may include medications and changes to your lifestyle. Your treatment plan may include:
Contact your healthcare provider if you have any symptoms of metabolic acidosis or symptoms of a condition that may cause metabolic acidosis.
Metabolic acidosis involves your digestive system and your urinary system. Your kidneys can’t properly filter acids from your bloodstream. Kidney disease, kidney failure, untreated diabetes, loss of bicarbonate and blood poisoning may cause a more acidic pH in your body.
Respiratory acidosis involves your respiratory system. Your lungs can’t remove enough carbon dioxide from your bloodstream. Asthma, brain injuries and excessive or disordered substance use may affect your lungs’ ability to remove carbon dioxide.
A note from Cleveland Clinic
Metabolic acidosis is a condition that causes acids to build up in your body. You may try to ignore or push through some common signs of metabolic acidosis. However, they’re your body’s way of telling you something isn’t right. If you have any symptoms, speak to your healthcare provider, especially if you have any conditions that affect your kidneys. They’re here to help.
Last reviewed by a Cleveland Clinic medical professional on 11/23/2022.
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