Metabolic acidosis

Definition

Metabolic acidosis is a condition characterized by an excess of acid in the body due to increased acid production, decreased acid excretion, or a loss of bicarbonate. This disruption can lead to significant alterations in fluid, electrolyte, and acid-base balance, affecting various body systems, particularly the kidneys and metabolic pathways involved in maintaining homeostasis.

5 Must Know Facts For Your Next Test

1. Common causes of metabolic acidosis include diabetic ketoacidosis, chronic diarrhea, renal failure, and lactic acidosis.
2. The body's compensatory mechanisms for metabolic acidosis include hyperventilation to decrease carbon dioxide levels, thereby raising blood pH.
3. Metabolic acidosis can lead to severe physiological effects if not corrected, including decreased cardiac contractility and impaired oxygen delivery to tissues.
4. The anion gap is crucial for diagnosing the underlying cause of metabolic acidosis; an increased anion gap suggests the presence of unmeasured anions.
5. Treatment for metabolic acidosis often involves addressing the underlying cause and may include administering bicarbonate in severe cases to help restore normal pH levels.

Review Questions

• How do the kidneys contribute to the regulation of acid-base balance and what happens during metabolic acidosis?
  • The kidneys play a crucial role in maintaining acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate. In metabolic acidosis, the kidneys may become overwhelmed or damaged, leading to inadequate hydrogen ion excretion and bicarbonate reabsorption. This results in a decreased blood pH and an accumulation of acids in the body, demonstrating the critical link between renal function and acid-base homeostasis.
• What clinical assessments are used to determine if a patient has metabolic acidosis and its underlying causes?
  • To diagnose metabolic acidosis, healthcare providers perform arterial blood gas analysis to measure pH, bicarbonate levels, and partial pressure of carbon dioxide. Additionally, calculating the anion gap helps identify specific etiologies; a high anion gap indicates conditions like diabetic ketoacidosis or lactic acidosis. Understanding these assessments is essential for providing appropriate treatment and management of patients with this condition.
• Evaluate the implications of untreated metabolic acidosis on overall patient health and potential complications.
  • Untreated metabolic acidosis can lead to significant complications, including cardiovascular issues such as arrhythmias and decreased cardiac output due to altered pH levels affecting heart function. Furthermore, prolonged acidosis can impair oxygen delivery at the cellular level and disrupt cellular metabolism, leading to multi-organ dysfunction. Therefore, recognizing and addressing metabolic acidosis promptly is vital for preventing severe health consequences and improving patient outcomes.

Related terms

bicarbonate: A key buffer in the blood that helps regulate pH levels by neutralizing acids.

anion gap: A measurement used to help determine the cause of metabolic acidosis by assessing the balance of electrolytes in the blood.

renal failure:

A condition where the kidneys fail to adequately filter waste products from the blood, often leading to metabolic acidosis due to reduced acid excretion.