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Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance.Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. [5]
Accumulation of lactate and carbon dioxide during the ischemic period largely accounts for the metabolic acidosis seen in PCAS patients, though strong ion gaps and phosphate also plays a role. [16] Worse acidosis is generally predictive of worse outcomes. [17]
In general, the cause of a hyperchloremic metabolic acidosis is a loss of base, either a gastrointestinal loss or a renal loss [citation needed]. Gastrointestinal loss of bicarbonate (HCO − 3) [citation needed] Severe diarrhea (vomiting will tend to cause hypochloraemic alkalosis) Pancreatic fistula with loss of bicarbonate rich pancreatic fluid
Treatment of uncompensated metabolic acidosis is focused upon correcting the underlying problem. When metabolic acidosis is severe and can no longer be compensated for adequately by the lungs or kidneys, neutralizing the acidosis with infusions of bicarbonate may be required.
The most serious form occurs during various states of shock, due to episodes of decreased liver perfusion. Kidney failure results in decreased acid excretion and increased bicarbonate excretion. Toxins that result in acidic metabolites may trigger lactic acidosis. Rhabdomyolysis, a muscle-wasting disease, is a rare cause of metabolic acidosis.
As of 2018, at least seven reported cases of severe metabolic acidosis occurring during pregnancy have been reported in PHA2 patients. [19] A study in 2023 also described a patient with severe preeclampsia later being diagnosed with PHA2D associated with chronic hyperkalemia and hyperchloremic metabolic acidosis. The twin babies were born ...
Hypoaldosteronism causes low sodium (hyponatremia), high potassium (hyperkalemia), and metabolic acidosis, a condition in which the body produces excess acid.These conditions are responsible for the symptoms of hypoaldosteronism, which include muscle weakness, nausea, palpitations, irregular heartbeat, and abnormal blood pressure.
Metabolic acidosis, hyperkalemia, and pulmonary edema may require medical treatment with sodium bicarbonate, antihyperkalemic measures, and diuretics. [33] Lack of improvement with fluid resuscitation, therapy-resistant hyperkalemia, metabolic acidosis, or fluid overload may necessitate artificial support in the form of dialysis or ...