Metabolic acidosis happens when your body is more acidic than basic. This condition is also called acute metabolic acidosis. It’s a common side effect of some chronic and urgent health problems. Acidosis can happen at any age; it can affect babies, children, and adults.

Normally, your body has an acid-base balance. It’s measured by the pH level. The body’s chemical level can become more acidic for many reasons. Metabolic acidosis can happen if you are:

  • making too much acid
  • making too little base
  • not clearing out acids fast or well enough

Metabolic acidosis can be mild and temporary to serious and life-threatening. You may need medical treatment. This condition can affect how your body functions. Too many acids in the body can also lead to other health problems.

Treatment for metabolic acidosis depends on the cause. Some causes are temporary and the acidosis will go away without treatment.

This condition can also be a complication of other chronic health problems. Treating the underlying condition may help prevent or treat the metabolic acidosis.

Metabolic acidosis is acidosis due to changes that affect the blood circulation, kidneys, or digestion. This may be caused by:

  • Diabetic ketoacidosis. The body burns fats instead of sugars, causing ketones or acids to build up.
  • Diarrhea. Severe diarrhea or vomiting can lead to hyperchloremic acidosis. This causes low levels of base called bicarbonate, which help to balance acids in the blood.
  • Poor kidney function. Kidney disease and kidney failure can lead to renal tubular acidosis. This happens when your kidneys can’t get filter out acids through the urine properly.
  • Lactic acidosis. This occurs when the body overproduces or underutilizes lactic acid. Causes include heart failure, cardiac arrest, and severe sepsis.
  • Diet. Eating excess animal products may make more acids in the body.
  • Exercise. The body makes more lactic acid if you’re not getting enough oxygen for a long time during intense exercise.

Other causes of acidosis include:

  • alcohol or drug abuse
  • drugs that slow breathing like benzodiazepines, sleep medications, pain medications, and certain narcotics

Conditions like asthma, chronic obstructive pulmonary disease (COPD), pneumonia, and sleep apnea can cause another kind of acidosis called respiratory acidosis. This happens if the lungs are not able to breathe out carbon dioxide properly. Too much carbon dioxide raises blood acid levels.

Treatment for metabolic acidosis works in three main ways:

  • excreting or getting rid of excess acids
  • buffering acids with a base to balance blood acidity
  • preventing the body from making too many acids

Other kinds of treatment for metabolic acidosis include:

Respiratory compensation

If you have respiratory acidosis, blood gas tests will show high carbon dioxide levels. Other tests to diagnose this kind of metabolic acidosis include breathing tests to show how well the lungs are working, and a chest X-ray or CT scan to check for lung infection or blockage.

Respiratory treatments for metabolic acidosis include:

Metabolic compensation

Diabetes treatment

Resolving metabolic acidosis caused by untreated or uncontrolled diabetes includes treatment for diabetes. If you have diabetic ketoacidosis, your blood tests will show high blood sugar levels (hyperglycemia). Treatment includes balancing blood sugar levels to help the body remove and stop making acids:

  • insulin
  • diabetes medications
  • fluids
  • electrolytes (sodium, chloride, potassium)

Insulin treatment will only work if diabetes is causing the metabolic acidosis.

IV sodium bicarbonate

Adding base to counter high acids levels treats some types of metabolic acidosis. Intravenous (IV) treatment with a base called sodium bicarbonate is one way to balance acids in the blood. It ‘s used to treat conditions that cause acidosis through bicarbonate (base) loss. This can happen due to some kidney conditions, diarrhea, and vomiting.


Dialysis is a treatment for serious kidney disease or kidney failure. Blood tests for chronic kidney problems will show high levels of urea and other kinds of acid. A urine test can also show how well the kidneys are working.

Dialysis helps to remove extra acids and other wastes from the blood. In hemodialysis, a machine filters the blood and removes wastes and extra fluids. Peritoneal dialysis is a treatment that uses a solution inside your body to absorb wastes.

Other treatments for metabolic acidosis

  • Inotropes and other medications help improve heart function in conditions like low blood pressure and heart failure. This improves oxygen flow to the body and lowers blood acid levels. Blood pressure readings, blood tests, and an ECG (electrocardiogram) will show if a heart problem is causing the metabolic acidosis.
  • Metabolic acidosis due to alcohol or drug poisoning is treated with detoxification. Some people may also need hemodialysis to clear out toxins. Blood tests including liver function tests will show an acid-base imbalance. A urine test and blood gas test can also show how serious the poisoning is.

Metabolic acidosis is a type of acidosis that’s usually caused by health conditions that affect the kidneys, heart, digestion, or metabolism. Acids build up in the blood and can lead to serious health complications if left untreated.

Treatment for metabolic acidosis depends on the underlying condition. Some types are mild or temporary and do not need treatment. Metabolic acidosis may be a sign that something is wrong in your body. You may need treatment for another health condition to balance acids and bases in your blood.

If you have metabolic acidosis or have a chronic condition that can cause acidosis, see your doctor regularly. Take all medications as prescribed and follow diet recommendations. Routine blood tests and other check-ups can help keep your acid-base levels balanced.