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Acidosis

URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/001181.htm


Acidosis is a condition in which there is excessive acid in the body fluids. It is the opposite of alkalosis
(a condition in which there is excessive base in the body fluids).
Causes
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 acidosisrespiratory acidosis or metabolic acidosismetabolic acidosis.
Respiratory acidosis develops when there is too much carbon dioxide (an acid) in the body. This type of
acidosis is usually caused by a decreased ability to remove carbon dioxide from the body through
effective breathing. Other names for respiratory acidosis are hypercapnic acidosis and carbon dioxide
acidosis. Causes of respiratory acidosis include:
• Chest deformities, such as kyphosis
• Chest injuries
• Chest muscle weakness
• Chronic lung disease
• Overuse of sedative drugs
Metabolic acidosis develops when too much acid is produced or when the kidneys cannot remove
enough acid from the body. There are several types of metabolic acidosis:
• Diabetic acidosisDiabetic acidosis (also called diabetic ketoacidosis and DKA) develops
when substances called ketone bodies (which are acidic) build up during uncontrolled diabetesdiabetes.
• Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body,
as can happen with severe diarrhea.
• Lactic acidosisLactic acidosis is a buildup of lactic acidlactic acid. This can be caused by:
o Alcohol
o Cancer
o Exercising vigorously for a very long time
o Liver failure
o Low blood sugar (hypoglycemia)
o Medications such as salicylates
o Prolonged lack of oxygen from shock, heart failure, or severe anemia
o Seizures
Other causes of metabolic acidosis include:
• Kidney diseaseKidney disease (distal renal tubular acidosisdistal renal tubular acidosis and
proximal renal tubular acidosisproximal renal tubular acidosis)
• Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol
• Severe dehydration
Metabolic acidosis is a condition in which there is too much acid in the body fluids.
Causes
Metabolic acidosis occurs when the body produces too much acid, or when the kidneys are not removing
enough acid from the body. There are several types of metablic acidosis:
• Diabetic acidosis (also called diabetic ketoacidosisdiabetic ketoacidosis and DKA)
develops when substances known as ketone bodies, which are acidic, build up during uncontrolled
diabetes
• Hyperchloremic acidosis results from excessive loss of sodium bicarbonate from the body,
as can happen with severe diarrhea
• Lactic acidosis is a buildup of lactic acid. It can be caused by:
o Alcohol
o Cancer
o Exercising for a very long time
o Liver failure
o Low blood sugar (hypoglycemia)
o Medications such as salicylates
o Prolonged lack of oxygen from shockshock, heart failureheart failure, or severe
anemiaanemia
o SeizuresSeizures
Other causes of metabolic acidosis include:
• Kidney disease Kidney disease (distal tubular acidosis and proximal renal tubular acidosis)
• Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol
• Severe dehydrationdehydration
Symptoms
Most symptoms are caused by the underlying disease or condition that is causing the metabolic acidosis.
Metabolic acidosis itself usually causes rapid breathing. Confusion or lethargy may also occur. Severe
metabolic acidosis can lead to shock or death. In some situations, metabolic acidosis can be a mild,
chronic (ongoing) condition.
Exams and Tests
• Arterial blood gas
• Serum electrolytes
• Urine pH
Arterial blood gas analysis or a serum electrolytes test (such as a basic metabolic panel) will confirm
acidosis is present and determine whether it is respiratory acidosisrespiratory acidosis or metabolic
acidosis.
Other test may be needed to determine the cause of the acidosis.
Treatment
Treatment is aimed at the underlying condition. In certain circumstances, sodium bicarbonate (baking
soda) may be given to improve the acidity of the blood.
Outlook (Prognosis)
What can be expected will depend on the underlying disease causing the metabolic acidosis.
Possible Complications
When very severe, metabolic acidosis can lead to shock or death.
When to Contact a Medical Professional
Seek medical treatment if you develop symptoms of any disease that can cause metabolic acidosis.
Prevention
Keeping type 1 diabetestype 1 diabetes under control may help prevent diabetic ketoacidosis, one type
of metabolic acidosis.
Respiratory acidosis
URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/000092.htm
Respiratory acidosis is a condition that occurs when the lungs cannot remove all of the carbon dioxide
the body produces. This disrupts the body's acid-base balance causing body fluids, especially the blood,
to become too acidic.
Causes
Causes of respiratory acidosis include:
• Diseases of the airways (such as asthmaasthma and chronic obstructive lung diseasechronic
obstructive lung disease), which send air into and out of the lungs
• Diseases of the chest (such as scoliosisscoliosis), which make the lungs less efficient at
filling and emptying
• Diseases affecting the nerves and muscles that "signal" the lungs to inflate or deflate
• Drugs that suppress breathing (including powerful pain medicines, such as narcotics, and
"downers," such as benzodiazepines), especially when combined with alcohol
• Severe obesity, which restricts how much the lungs can expand
Chronic respiratory acidosis occurs over a long period of time. This leads to a stable situation, because
the kidneys increase body chemicals, such as bicarbonate, that help restore the body's acid-base balance.
Acute respiratory acidosis is a severe condition in which carbon dioxide builds up very quickly and
before the kidneys can return the body to a state of balance.
Symptoms
Symptoms may include:
• Confusion
• Easy fatigue
• Lethargy
• Shortness of breath
• Sleepiness
Exams and Tests
• Arterial blood gasblood gas (measures levels of oxygen and carbon dioxide in the blood; in
respiratory acidosis, the level of carbon dioxide is too high)
• Chest x-rayChest x-ray
• Pulmonary function testPulmonary function test
Treatment
Treatment is aimed at the underlying lung disease, and may include:
• Bronchodilator drugs to reverse some types of airway obstruction
• Noninvasive positive-pressure ventilation (sometimes called CPAPCPAP or BiPAP) or
mechanical ventilation if needed
• Oxygen if the blood oxygen level is low
• Treatment to stop smokingstop smoking
Outlook (Prognosis)
How well you do depends on the disease causing the respiratory acidosis.
Possible Complications
• Poor organ function
• Respiratory failure
• ShockShock
When to Contact a Medical Professional
Severe respiratory acidosis is a medical emergency. Seek immediate medical help if you have symptoms
of this condition.
Call your health care provider if you have symptoms of lung disease.
Prevention
Do not smoke. Smoking leads to the development of many severe lung diseases that can cause
respiratory acidosis.
Losing weight may help prevent respiratory acidosis due to obesity (obesity-hypoventilation syndrome).
Be careful about taking sedating medicines, and never combine these medicines with alcohol.
Alkalosis
URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/001183.htm
Alkalosis is a condition in which the body fluids have excess base (alkali). This is the opposite of excess
acid (acidosisacidosis).
Causes
The kidneys and lungs maintain the proper balance of chemicals, called acids and bases, in the body.
Decreased carbon dioxide (an acid) or increased bicarbonate (a base) levels make the body too alkaline,
a condition called alkalosis.
Respiratory alkalosis is caused by low carbon dioxide levels in the blood. This can be due to:
• Fever
• Being at a high altitude
• Lack of oxygen
• Liver disease
• Lung disease, which causes you to breathe faster (hyperventilatehyperventilate)
• Salicylate poisoning
Metabolic alkalosis is caused by too much bicarbonate in the blood.
Hypochloremic alkalosis is caused by an extreme lack or loss of chloride, which can occur with
prolonged vomiting.
Hypokalemic alkalosis is caused by the kidneys' response to an extreme lack or loss of potassium, which
can occur when people take certain diuretic medications.
Compensated alkalosis occurs when the body returns the acid - base balance to normal in cases of
alkalosis, but bicarbonate and carbon dioxide levels remain abnormal.
Symptoms
• ConfusionConfusion (can progress to stupor or coma)
• Hand tremor
• Lightheadedness
• Muscle twitching
• Nausea, vomiting
• Numbness or tingling in the face or extremities
• Prolonged muscle spasmsmuscle spasms (tetany)
Exams and Tests
An arterial blood gas analysis or basic metabolic panel will confirm alkalosis and determine if it is a
respiratory alkalosis or a metabolic alkalosis. Other tests may be needed to determine the cause of the
alkalosis. These may include:
• Litmus paper (urine dipstick tests)
• UrinalysisUrinalysis
• Urine pHUrine pH
Treatment
Treatment of alkalosis depends on finding the specific cause.
For alkalosis caused by hyperventilation, breathing into a paper bag causes you to retain more carbon
dioxide and improves the alkalosis. If your oxygen level is low, you may receive oxygen to help the
alkalosis.
Some people need medications to correct chemical loss (such as chloride and potassium). Your health
care provider will monitor your vital signsvital signs (temperature, pulse, rate of breathing, blood
pressure).
Outlook (Prognosis)
Most cases of alkalosis respond well to treatment.
Possible Complications
• ArrhythmiasArrhythmias
• Coma
• ElectrolyteElectrolyte imbalance (such as hypokalemiahypokalemia)
When to Contact a Medical Professional
Call your health care provider if you become confused, unable to concentrate, or unable to "catch your
breath."
A visit to the emergency room or call to the local emergency number (such as 911) is warranted for:
• Loss of consciousness
• Rapidly worsening symptoms of alkalosis
• SeizuresSeizures
• Severe breathing difficulties
Prevention
Prevention depends on the cause of the alkalosis. Normally, people with healthy kidneys and lungs do
not have significant alkalosis.