Acidosis (Metabolic and Respiratory), Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications

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Acidosis (Metabolic and Respiratory), Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications

Acidosis is a condition that occurs when the levels of acid in the body are very high. This condition is characterized by symptoms such as shortness of breath, confusion, headaches, and decreased consciousness. Acidosis is a condition that can be fatal if not treated immediately.

Normally, the pH of the blood in the blood is around 7.4. Acidosis occurs when the blood pH is less than 7.35 (acidic). This is different from alkalosis, which is a condition when the blood pH is more than 7.45 (alkaline). This change in pH will greatly affect the function and work of various organs of the body.

Causes of Acidosis


Acidosis is caused by a disturbance in the acid-base balance in the body. As a result, acid levels in the body become very high. This condition can occur as a result of:

  • Excessive acid production
  • Impaired acid secretion
  • The process of acid-base balance in the body that is not normal


These three conditions can be caused by disorders of acid metabolism in the body (metabolic acidosis), or disturbances in the process of exchange of oxygen and carbon dioxide (respiratory acidosis). Here is the explanation:

Metabolic acidosis

Metabolic acidosis occurs when the body produces too much acid or when the kidneys are unable to remove acid from the body. There are several types of acidosis including metabolic acidosis, namely:

1. Diabetic acidosis

Diabetic acidosis or diabetic ketoacidosis is caused by excess production of ketones. This condition occurs when diabetes is not controlled.

2. Lactic acidosis
Lactic acidosis is caused by excessive production of lactic acid due to low oxygen levels in the body.

Some of the causes are:

  • Cancer
  • Excessive consumption of alcoholic beverages
  • Heart failure
  • Heart failure
  • Hypoglycemia in the long term
  • Sepsis


3. Hyperchloremic acidosis
Increased acid levels in the body in this condition occur due to excessive bicarbonate loss over a long time. Hyperchloremic acidosis is usually caused by gastrointestinal disorders and kidney disease.

4. Renal tubular acidosis
This condition occurs when the kidneys can't get rid of acid through urine, so acid builds up in the blood. This usually occurs when kidney damage is caused by an autoimmune disease or genetic disorder.

Respiratory acidosis

Respiratory acidosis also increases acid levels in the body, but by a different mechanism. This condition occurs when the level of carbon dioxide in the blood increases due to problems in the respiratory system, such as:

  • Respiratory disorders, such as asthma and COPD (chronic obstructive pulmonary disease)
  • Disorders of lung tissue, such as pulmonary fibrosis
  • Disorders of the sternum that can affect breathing, such as scoliosis and kyphosis
  • Nervous system disorders that affect breathing, such as myasthenia gravis, Guillain-BarrĂ© Syndrome, and ALS (amyotrophic lateral sclerosis)
  • Use of drugs that can affect the respiratory system, such as the use of opioids or a combination of benzodiazepine drugs with alcohol
  • Other conditions that can affect breathing, such as obesity and sleep apnea


Symptoms of Acidosis


Symptoms of acidosis depend on the cause, whether it is a disorder of acid metabolism (metabolic acidosis) or impaired exchange of oxygen and carbon dioxide (respiratory acidosis).
The following are some of the symptoms of metabolic acidosis:

  • Short and fast breath
  • Headache
  • Dazed
  • Nausea and vomiting
  • Tired or sleepy
  • Loss of appetite
  • Heart rate increases
  • Jaundice
  • Bad breath smells like fruity smell

Meanwhile, some of the symptoms of respiratory acidosis can include:

  • Short and fast breath
  • Tired or sleepy
  • Headache
  • Nervous
  • Dizzy
  • Dazed
  • Seizures


Patients who experience respiratory acidosis in the long term (chronic) do not always show symptoms as above. However, symptoms such as memory loss, sleep disturbances, and behavioral changes, can occur from time to time.

When to go to the doctor

Early detection and treatment can help reverse acidosis. Therefore, immediately consult a doctor if you experience the symptoms of acidosis as described above.
Keep in mind that acidosis is a serious condition and can be fatal. Make sure you go to the hospital immediately if you have difficulty breathing or if other symptoms worsen.

Acidosis can be triggered by diseases such as diabetes, asthma, and COPD. Get regular checkups and checkups if you have this condition to prevent acidosis.

Diagnosis of Acidosis


To diagnose acidosis, the doctor will ask about the symptoms experienced, the medications being used, as well as the patient's and family's medical history. After that, the doctor will perform a thorough physical examination.

The doctor will also perform several supporting tests to confirm the diagnosis, determine the severity of the acidosis, and to determine the underlying cause. Checks that can be done are:

  • Blood tests, to assess overall metabolic function, including kidney function, sugar levels, and electrolytes
  • Arterial blood gas analysis, to measure the levels of oxygen, carbon dioxide and pH in the blood
  • Urine test, to detect the presence of ketones and the level of acid excreted through urine
  • Chest X-ray, to detect injury or other disorders in the lungs
  • Pulmonary function tests, to determine the condition and function of the lungs and respiratory tract
  • Scanning with a CT scan, to examine in detail certain diseases or conditions in the chest that can trigger acidosis


Acidosis Treatment


Acidosis treatment will be tailored to the type, cause, and severity of acidosis. Here is the explanation:

Metabolic acidosis

Treatment of metabolic acidosis largely depends on the cause. In cases of hyperchloremic acidosis, the doctor will usually give sodium bicabornate, it can be in the form of tablets or liquid that is injected into a vein.

For renal tubular acidosis, the doctor may prescribe sodium citrate and treat the patient's kidney problems. Meanwhile, in patients with diabetic acidosis, doctors will give insulin along with intravenous fluids to balance acid levels.

In people with lactic acidosis, some medications, such as sodium bicarbonate, antibiotics, intravenous fluids, or oxygen, can be given. If the condition is not too severe, detoxification can be done, especially if the patient has drug or alcohol poisoning.

Respiratory acidosis

Treatment of respiratory acidosis aims to improve lung function. In cases of acute respiratory acidosis, treatment is carried out by treating the cause. While the treatment of chronic respiratory acidosis is usually done to prevent the condition from getting worse.

Generally, the doctor will give antibiotics, corticosteroids, bronchodilators, or diuretics. If the patient's condition is severe enough, the doctor can perform a procedure for installing a breathing apparatus (ventilator) called continuous positive airway pressure (CPAP).

Complications of Acidosis


Metabolic acidosis and respiratory acidosis that are not treated immediately can lead to different complications. Some of the complications that can occur due to metabolic acidosis are:

  • Kidney failure
  • Osteoporosis
  • Loss of muscle mass
  • Diabetes
  • Kidney stones
  • Developmental delay


Meanwhile, complications that can occur due to respiratory acidosis are:

  • Decreased oxygen levels in the blood (hypoxemia)
  • Brain damage due to lack of oxygen
  • Pulmonary hypertension
  • Heart failure


Although they can cause different complications, untreated metabolic acidosis and respiratory acidosis are both at risk of causing shock or even death.

Acidosis Prevention


Not all types of acidosis can be prevented. However, there are several ways that can be done to reduce the risk of this condition, namely:

  • Undergo medication and regular control if suffering from diseases that can cause acidosis, such as diabetes, asthma, and COPD
  • Taking medicines as recommended by the doctor
  • Drink more water
  • Maintain ideal body weight
  • Do not smoke
  • Not abusing drugs
  • Do not consume alcoholic beverages
  • See a doctor immediately if you experience severe vomiting or diarrhea

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