Acidosis is a condition characterized by 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 major 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. For example, if the acidosis was caused by excessive carbon dioxide (which is an acid) the body will correct the pH by retaining bicarbonate (a base).

Respiratory acidosis develops when there are excessive amounts of carbon dioxide in the body, primarily caused by decreased breathing. Other names for this include hypercapnic acidosis and carbon dioxide acidosis.

There are several types of metabolic acidosis. Diabetic acidosis (also called diabetic ketoacidosis and DKA) develops when ketone bodies accumulate during uncontrolled Diabetes.

Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body, as in severe diarrhea, for example.

Lactic 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, seizures, hypoglycemia (low blood sugar), alcohol, liver failure, malignancy, or certain medications like salicylates.

Other causes of metabolic acidosis include severe dehydration - resulting in decreased tissue perfusion (decreased blood flow), kidney disease (see Distal renal tubular acidosis and Proximal renal tubular acidosis), and other metabolic diseases.

See the specific types of acidosis.

Signs and tests
An arterial blood gas analysis or a blood chemistry, such as a Chem-20, will confirm acidosis in most cases. Other tests may be needed to determine the cause of the acidosis.

Treatment depends on the cause. See the specific types of acidosis.

Expectations (prognosis)
Acidosis can be dangerous if untreated. Many causes respond adequately to treatment.

See the specific types of acidosis.

Calling your health care provider
Although there are several types of acidosis, all will cause symptoms that require treatment by your health care provider. (See the specific types of acidosis.)

Prevention or treatment of the underlying causes may prevent some cases of acidosis.

Johns Hopkins patient information

Last revised: December 6, 2012
by Simon D. Mitin, M.D.

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