Acidosis

Written by Suzanne Allen and Elizabeth Boskey, PhD | Published on July 16, 2012
Medically Reviewed by George Krucik, MD

What is Acidosis?

When your body fluids contain too much acid, this is known as acidosis. Acidosis occurs when your kidneys and lungs can’t keep your body’s pH in balance.

There are two types of acidosis--metabolic and respiratory. Metabolic acidosis occurs when your kidneys can’t get rid of acid buildup or when your body gets rid of too much base. Bases neutralize acids, and vice versa. Respiratory acidosis occurs when your lungs do not properly eliminate the carbon dioxide (CO2). When CO2 builds up in your blood, it becomes more acidic.

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Causes and Risk Factors for Acidosis

The acidity of your blood is measured by determining its pH. A lower pH means that your blood is more acidic. A higher pH means that your blood is more basic. The pH of your blood should be around 7.4.

Many of the body’s processes produce acid. Your lungs and kidneys can usually compensate for slight pH imbalances. However, problems with these organs can lead to acidosis.

Respiratory Acidosis

Respiratory acidosis occurs when too much CO2 builds up in the body. Normally the lungs remove CO2 while you breathe. However, sometimes your body can’t get rid of enough CO2. This may happen because of:

  • chronic airway conditions, like asthma
  • injury to the chest
  • obesity, which can make breathing difficult
  • sedative misuse, including overuse of alcohol
  • muscle weakness in the chest
  • problems with the nervous system
  • deformed chest structure

Metabolic Acidosis

Metabolic acidosis starts in the kidneys instead of the lungs. It occurs when they can’t eliminate enough acid or when they get rid of too much base. There are three major forms of metabolic acidosis:

  • Diabetic acidosis occurs in people with poorly managed diabetes. Ketones build up in the body and acidify the blood.
  • Hyperchloremic acidosis results from a loss of sodium bicarbonate. This base helps to keep the blood neutral. Both diarrhea and vomiting can cause this type of acidosis.
  • Lactic acidosis occurs when there is too much lactic acid in your body. Many things can cause a buildup of lactic acid. These include chronic alcohol use, heart failure, cancer, seizures, liver failure, prolonged lack of oxygen, and low blood sugar. Even prolonged exercise can lead to lactic acid buildup!

Other factors that can contribute to your risk of metabolic acidosis include:

  • eating a high-fat, low-carbohydrate diet
  • kidney failure
  • dehydration
  • aspirin or methanol poisoning

Symptoms of Acidosis

Both respiratory and metabolic acidosis share many symptoms. However, the symptoms of acidosis do vary based on its cause. Some of the common symptoms include:

Respiratory Acidosis

  • fatigue
  • becoming tired easily
  • confusion
  • shortness of breath
  • sleepiness

Metabolic Acidosis

  • rapid and shallow breathing
  • confusion
  • fatigue
  • headache
  • sleepiness
  • lack of appetite
  • breath that smells fruity – this is a sign of diabetic acidosis/ketoacidosis

Tests and Diagnosis

If you think you may have acidosis, go to the doctor immediately. Early diagnosis can make a big difference in your recovery.

Doctors diagnose acidosis with a series of blood tests. An arterial blood gas looks at the levels of oxygen and carbon dioxide in your blood. It also reveals your blood pH. A basic metabolic panel checks your kidney functioning and your pH balance. It also measures your calcium, protein, blood sugar, and electrolyte levels. Taken together, these tests can identify the different types of acidosis.

If you are diagnosed with respiratory acidosis, your doctor will want to check the health of your lungs. This may involve a chest X-ray or a pulmonary function test. If metabolic acidosis is suspected, you will need to provide a urine sample. Doctors will check the pH to see if you are properly eliminating acids and bases. Additional tests may be needed to determine the cause of your acidosis.

Treatments

Doctors usually need to know what is causing your acidosis in order to treat it. However, some treatments can be used for any type of acidosis. For example, your doctor may give you sodium bicarbonate (baking soda) to raise the pH of your blood. This can be done either by mouth or in an intravenous (IV) drip. Other types of acidosis are often treated by treating their cause.

Respiratory Acidosis

Treatments for this condition are usually designed to help your lungs. For example, you may be given drugs to dilate your airway. You might also be given oxygen or hooked up to a continuous positive airway pressure (CPAP) device. The CPAP can help you breathe if you have an obstructed airway or muscle weakness.

Metabolic Acidosis

The specific types of metabolic acidosis each have their own treatments. People with hyperchloremic acidosis are given oral sodium bicarbonate. Acidosis from kidney failure can be treated with sodium citrate. Diabetics with ketoacidosis receive IV fluids and insulin to balance out their pH. Lactic acidosis treatment might include bicarbonate supplements, IV fluids, oxygen, or, antibiotics, depending on the cause.

Acidosis Prognosis

How well you recover from acidosis depends on its cause. Quick, correct treatment also has a strong influence on your recovery.

Some individuals fully recover from acidosis. Others have problems with organ function, respiratory failure, and kidney failure. Severe acidosis can cause shock or even death.

Acidosis Prevention

You can’t completely prevent acidosis. However, there are some things you can do to lower your risk.

To Reduce The Risk of Respiratory Acidosis:

  • Take sedatives as prescribed and never mix them with alcohol.
  • Stop smoking. Smoking can damage your lungs and make breathing less effective.
  • Maintain a healthy weight. Obesity can make it harder for you to breathe.

To Reduce The Risk of Metabolic Acidosis:

  • Stay hydrated. Drink plenty of water and other fluids.
  • Keep control of your diabetes. If you manage your blood sugar levels well, you can avoid ketoacidosis.
  • Stop drinking alcohol. Chronic drinking can increase lactic acid buildup.
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