Acidosis - metabolic

Alternative names
Metabolic acidosis


Metabolic acidosis is a disturbance of the body acid-base balance in which there is excessive acidity of the blood. Metabolic acidosis can occur as a result of many different conditions, such as kidney failure, poisoning, diabetic ketoacidosis (DKA), and shock.

Many of these conditions are life-threatening. If severe, metabolic acidosis may lead to shock or death. In some situations, metabolic acidosis can be a mild, chronic condition.

Causes, incidence, and risk factors

Many different diseases and medical conditions can lead to metabolic acidosis. For example, diabetes mellitus type 1 (juvenile diabetes), when out of control, leads to diabetic ketoacidosis.

Kidney failure is another important cause of metabolic acidosis. Ingestion of toxic substances, such as antifreeze or excessive amounts of aspirin, can also lead to metabolic acidosis. Shock (extremely low blood pressure) can also cause this condition.

Most symptoms are caused by the disease or condition that is causing the metabolic acidosis. Metabolic acidosis itself usually causes rapid breathing. Confusion or lethargy may also occur.

Signs and tests

Blood tests to diagnose metabolic acidosis may include:

  • An arterial blood gas to assess the severity of the metabolic acidosis  
  • A metabolic panel to reveal the cause and severity of the metabolic acidosis  
  • A complete blood count (CBC) to assess possible causes of metabolic acidosis

Treatment is aimed at the underlying condition. In certain circumstances, sodium bicarbonate (baking soda) may be given to improve the acidity of the blood.

Expectations (prognosis)
The prognosis of metabolic acidosis depends on the underlying disease.

When very severe, metabolic acidosis can lead to shock or death.

Calling your health care provider
Call your health care provider, or go to the nearest emergency room if symptoms of any disease that causes metabolic acidosis appear.


Keeping diabetes mellitus type 1 under control may avoid many cases of metabolic acidosis. Avoid ingesting toxic materials.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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