Acidosis
Acidosis is a condition in which there is too much acid in the body fluids. It is the opposite of alkalosis (a condition in which there is too much base in the body fluids).
Alkalosis
Alkalosis is a condition in which the body fluids have excess base (alkali). This is the opposite of excess acid (acidosis).
Read Article Now Book Mark ArticleCauses
The kidneys and lungs maintain the balance (proper pH level) of chemicals called acids and bases in the body. Acidosis occurs when acid builds up or when bicarbonate (a base) is lost. Acidosis is classified as either respiratory or metabolic acidosis.
Respiratory
Respiratory acidosis is a condition that occurs when your lungs can’t remove all of the carbon dioxide produced by your body. This causes the blood ...
Read Article Now Book Mark ArticleMetabolic acidosis
Metabolic acidosis is a condition in which there is too much acid in the body fluids.
Read Article Now Book Mark ArticleRespiratory acidosis develops when there is too much carbon dioxide (an acid) in the body. This type of acidosis is usually caused when the body is unable to remove enough carbon dioxide through breathing. Other names for respiratory acidosis are hypercapnic acidosis and carbon dioxide acidosis. Causes of respiratory acidosis include:
- Chest deformities, such as kyphosis
Kyphosis
Kyphosis is a curving of the spine that causes a bowing or rounding of the back. This leads to a hunchback or slouching posture.
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- Chest muscle weakness
- Long-term (chronic) lung disease
- Neuromuscular disorders, such as myasthenia gravis, amyotrophic lateral sclerosis or muscular dystrophy
- Overuse of sedative drugs, causing decreased respiration
- Acute lung disease, such as severe pneumonia or acute respiratory distress syndrome associated with severe medical illness
Metabolic acidosis develops when too much acid is produced in the body. It can also occur when the kidneys cannot remove enough acid from the body. There are several types of metabolic acidosis:
- Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when substances called ketone bodies (which are acidic) build up during uncontrolled diabetes (usually type 1 diabetes).
Diabetic acidosis
Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. It occurs when the body starts breaking down fat at a r...
Read Article Now Book Mark ArticleDiabetes
Diabetes is a long-term (chronic) disease in which the body cannot regulate the amount of sugar in the blood.
Read Article Now Book Mark Article - Hyperchloremic acidosis is caused by the loss of too much sodium bicarbonate from the body, which can happen with severe diarrhea.
- Kidney disease (uremia, distal renal tubular acidosis or proximal renal tubular acidosis).
Distal renal tubular acidosis
Distal renal tubular acidosis is a disease that occurs when the kidneys do not properly remove acids from the blood into the urine. As a result, too...
Read Article Now Book Mark ArticleProximal renal tubular acidosis
Proximal renal tubular acidosis is a disease that occurs when the kidneys don't properly remove acids from the blood into the urine. As a result, to...
Read Article Now Book Mark Article - Lactic acidosis.
- Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol.
- Severe dehydration.
Dehydration
Dehydration occurs when your body does not have as much water and fluids as it needs. Dehydration can be mild, moderate, or severe, based on how much...
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Lactic acidosis is a buildup of lactic acid. Lactic acid is mainly produced in muscle cells and red blood cells. It forms when the body breaks down carbohydrates to use for energy when oxygen levels are low. This can be caused by:
Lactic acidosis
Lactic acidosis refers to lactic acid build up in the bloodstream. Lactic acid is produced when oxygen levels become low in cells within the areas o...
Read Article Now Book Mark ArticleLactic acid
Lactic acid is mainly produced in muscle cells and red blood cells. It forms when the body breaks down carbohydrates to use for energy when oxygen l...
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- Carbon monoxide poisoning
Carbon monoxide poisoning
Carbon monoxide is an odorless gas that causes thousands of deaths each year in North America. Breathing in carbon monoxide is very dangerous. It i...
Read Article Now Book Mark Article - Drinking too much alcohol
- Exercising vigorously for a very long time
- Liver failure
- Low blood sugar (hypoglycemia)
- Medicines, such as salicylates, metformin, anti-retrovirals
- MELAS (a very rare genetic mitochondrial disorder that affects energy production)
- Prolonged lack of oxygen from shock, heart failure, or severe anemia
- Seizures
- Sepsis -- severe illness due to infection with bacteria or other germs
Sepsis
Sepsis is an illness in which the body has a severe, inflammatory response to bacteria or other germs.
Read Article Now Book Mark Article - Severe asthma
Compensated acidosis occurs when the body returns the acid-base balance to near normal in cases of acidosis, but bicarbonate and carbon dioxide levels remain abnormal.
Symptoms
Metabolic acidosis symptoms depend on the underlying disease or condition. Metabolic acidosis itself causes rapid and deep breathing as your body tries to compensate for it. Confusion or lethargy may also occur. Severe metabolic acidosis can lead to shock or death. In some situations, metabolic acidosis can be a mild, ongoing (chronic) condition.
Metabolic acidosis
Metabolic acidosis is a condition in which there is too much acid in the body fluids.
Read Article Now Book Mark ArticleRespiratory acidosis symptoms can include:
Respiratory acidosis
Respiratory acidosis is a condition that occurs when your lungs can’t remove all of the carbon dioxide produced by your body. This causes the blood ...
Read Article Now Book Mark Article- Confusion
- Fatigue
- Lethargy
- Shortness of breath
- Sleepiness
Exams and Tests
Your health care provider will perform a physical examination and ask about your symptoms.
These tests can help diagnose acidosis. They can also determine whether the cause is a breathing problem or a metabolic problem. Tests may include:
- Arterial or venous blood gas analysis
Arterial or venous blood gas analysis
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
Read Article Now Book Mark Article - Basic metabolic panel (group of blood tests that measure sodium and potassium levels, kidney function, and other chemicals and functions) to show whether the type of acidosis is metabolic or respiratory
Basic metabolic panel
The basic metabolic panel is a group of blood tests that provides information about your body's metabolism.
Read Article Now Book Mark Article - Blood ketones
Blood ketones
A ketone blood test measures the amount of ketones in the blood. Ketones can also be measured with a urine test.
Read Article Now Book Mark Article - Lactic acid test
Lactic acid test
Lactic acid is mainly produced in muscle cells and red blood cells. It forms when the body breaks down carbohydrates to use for energy when oxygen l...
Read Article Now Book Mark Article - Urine ketones
Urine ketones
A ketone urine test measures the amount of ketones in the urine.
Read Article Now Book Mark Article - Urine pH
Other blood tests may be needed to determine the cause of the acidosis.
Other tests that may be needed to determine the cause of the acidosis include:
- Chest x-ray
- CT abdomen
- Urinalysis
- Urine pH
Treatment
Treatment is aimed at the health problem causing the acidosis. In some cases, sodium bicarbonate (the chemical in baking soda) may be given to reduce the acidity of the blood. Often, you will receive lots of fluids through your vein.
Outlook (Prognosis)
Acidosis can be dangerous if untreated. Many cases respond well to treatment. The outlook will depend on the underlying disease causing the condition.
Possible Complications
Complications depend on the specific type of acidosis.
When to Contact a Medical Professional
All the types of acidosis will cause symptoms that require treatment by your provider.
Prevention
Prevention depends on the cause of the acidosis. Many causes of metabolic acidosis can be prevented, including diabetic ketoacidosis and some causes of lactic acidosis. Normally, people with healthy kidneys and lungs do not have serious acidosis.
References
Oh MS, Briefel G, Pincus MR. Evaluation of renal function, water, electrolytes, and acid-base balance. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 15.
Sanghavi S, Albert TJ, Swenson ER. Acid-base balance. In: Broaddus VC, Ernst JD, King TE, et al. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 12.
Seifter JL. Acid-base disorders. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 104.
Review Date: 11/19/2023
Reviewed By: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.