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metabolic acidosis

ICD-10 Codes

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Description

What is Metabolic Acidosis?

Metabolic acidosis is a condition characterized by an excessive amount of acid in the body fluids, leading to an abnormal decrease in blood pH levels [1]. This condition occurs when there is an imbalance between the production and removal of acids in the body, resulting in a buildup of hydrogen ions [2].

Key Features:

  • Excessive acid production or accumulation in the body
  • Abnormal increase in hydrogen ion concentration in systemic circulation
  • Compensatory reduction in bicarbonate (HCO3-) levels
  • Marked decrease in serum pH levels [3]
  • Can be life-threatening if not treated appropriately, especially in individuals with advanced Chronic Kidney Disease (CKD) [4]

Causes and Triggers:

  • Excessive production of acid in the body due to various medical conditions or processes
  • Inability of the kidneys to remove sufficient amounts of acid from the body
  • Certain medications or treatments that can lead to metabolic acidosis as a side effect

Symptoms and Complications:

  • Metabolic acidosis can manifest with symptoms such as:
    • Confusion, lethargy, or altered mental status
    • Weakness, fatigue, or muscle cramps
    • Abdominal pain, nausea, or vomiting
    • Shortness of breath or difficulty breathing
  • If left untreated, metabolic acidosis can lead to severe complications, including:
    • Respiratory failure
    • Cardiac arrest
    • Multi-organ failure

References:

[1] Metabolic acidosis is a condition in which there is too much acid in the body fluids. [2] Metabolic acidosis develops when too much acid is produced in the body. It can also occur when the kidneys cannot remove enough acid from the body. [3] Metabolic acidosis is primary reduction in bicarbonate (HCO3-), typically with compensatory reduction in carbon dioxide partial pressure (P); pH may be markedly decreased. [4] Metabolic acidosis is too much acid in the blood. It is more common in people with advanced CKD and can be life-threatening if not treated appropriately.

Note: The

Additional Characteristics

  • Cardiac arrest
  • Metabolic acidosis
  • Respiratory failure
  • Shortness of breath or difficulty breathing
  • Excessive acid production or accumulation in the body
  • Abnormal increase in hydrogen ion concentration in systemic circulation
  • Compensatory reduction in bicarbonate (HCO3-) levels
  • Marked decrease in serum pH levels
  • Life-threatening if not treated appropriately, especially in individuals with advanced Chronic Kidney Disease (CKD)
  • Excessive production of acid in the body due to various medical conditions or processes
  • Inability of the kidneys to remove sufficient amounts of acid from the body
  • Certain medications or treatments that can lead to metabolic acidosis as a side effect
  • Confusion, lethargy, or altered mental status
  • Weakness, fatigue, or muscle cramps
  • Abdominal pain, nausea, or vomiting
  • Multi-organ failure

Signs and Symptoms

Metabolic acidosis can manifest in various ways, and its signs and symptoms can be quite diverse. Here are some of the common indicators:

  • Rapid breathing: Metabolic acidosis itself causes rapid and deep breathing as your body tries to compensate for it [5]. This is often described as "air hunger" [2].
  • Kussmaul respirations: A form of hyperventilation that serves to increase minute ventilatory volume, which is the best recognized sign of metabolic acidosis [4].
  • Confusion or lethargy: Acting confused or very tired may also occur due to the body's inability to compensate for the acidosis [3].
  • Nausea and vomiting: These symptoms are frequently present, particularly in children [7]. Metabolic acidosis occurring in children is very rarely due to an inborn error.
  • Fatigue (feeling tired and weak): You may also experience fatigue as your body struggles to cope with the acidosis [8].
  • Changes in breathing: At first, breaths are usually fast and deep; as acidosis worsens, breathing becomes more labored [2].

It's essential to note that some people may not exhibit any symptoms at all, especially if the metabolic acidosis develops gradually. However, when symptoms do occur, they can be quite distressing.

References: [1] Not applicable (this is a summary of search results) [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 5 [6] Not applicable [7] Context result 7 [8] Context result 8

Additional Symptoms

  • Nausea and vomiting
  • Rapid breathing
  • Kussmaul respirations
  • Confusion or lethargy
  • Fatigue (feeling tired and weak)
  • Changes in breathing

Diagnostic Tests

Metabolic acidosis can be diagnosed through various diagnostic tests that help evaluate the condition and its underlying causes.

Blood Tests

Several blood tests are used to diagnose metabolic acidosis, including:

  • Anion Gap: This test measures the difference between the levels of chloride and bicarbonate ions in the blood, which helps identify the presence of metabolic acidosis [1].
  • Arterial Blood Gas (ABG): An ABG measures the pH level and electrolyte balance in the blood, providing valuable information about the acidity of the blood [3].
  • Basic Metabolic Panel: This group of tests assesses kidney function, sodium and potassium levels, and other essential parameters that can help diagnose metabolic acidosis [4].

Other Diagnostic Tests

In addition to blood tests, other diagnostic tests may be used to evaluate metabolic acidosis, including:

  • Electrolyte measurement: Measuring the levels of electrolytes such as sodium, potassium, and chloride in the blood can provide valuable information about the condition [6].
  • Toxin screening: In some cases, toxin screening may be necessary to identify the underlying cause of metabolic acidosis [6].

Winters Formula

The Winters formula is a mathematical calculation used to determine the severity of metabolic acidosis based on the anion gap and delta gap values [5].

These diagnostic tests can help healthcare professionals diagnose metabolic acidosis and develop an effective treatment plan.

References:

[1] Your healthcare provider may order an anion gap test to evaluate your blood chemistry. [3] The only definitive way to diagnose metabolic acidosis is by simultaneous measurement of serum electrolytes and arterial blood gases (ABGs). [4] Exams and Tests · Arterial or venous blood gas · Basic metabolic panel, (a group of blood tests that measure your sodium and potassium levels, kidney function, ... [5] Diagnosis of Metabolic Acidosis · Arterial blood gas (ABG) and serum electrolyte measurement · Anion gap and delta gap calculated · Winters formula for calculating ... [6] by MK Burger · 2023 · Cited by 26 — Lab tests that help evaluate metabolic acidosis are those that assess renal and lung function including electrolytes, venous or arterial blood gas, and toxin screening. [7] by B Jung · 2019 · Cited by 88 — Physicians have at their disposal numerous plasma and urine tests to characterize metabolic acidosis, determine its etiology, and refer patients.

Additional Diagnostic Tests

  • Anion Gap
  • Arterial Blood Gas (ABG)
  • Basic Metabolic Panel
  • Electrolyte measurement
  • Toxin screening
  • Winters Formula

Treatment

Treatment Options for Metabolic Acidosis

Metabolic acidosis can be treated through various methods, focusing on addressing the underlying cause and correcting the body's acid-base balance.

  • Nutritional Therapy: The primary approach to treating metabolic acidosis is through nutrition. A diet rich in alkaline-forming foods, such as fruits, vegetables, and whole grains, can help lower the body's acidity levels [1].
  • Alkali Therapy: In cases where nutritional therapy is insufficient, alkali therapy may be indicated to raise and maintain plasma pH above 7.20 [2]. This involves administering sodium bicarbonate to increase blood bicarbonate levels, which should be kept above 22 mEq/L [3].
  • Renal Replacement Therapy: For patients with renal failure or poisoning from substances like ethylene glycol, methanol, or salicylate, hemodialysis may be required to remove the toxic substance and correct acid-base imbalances [4].
  • Addressing Underlying Causes: Treatment is often directed at the underlying health problem causing metabolic acidosis. This may involve managing conditions such as kidney disease, diabetes, or poisoning [5].

Key Considerations

  • The goal of treatment is to correct the body's acid-base balance and address the underlying cause of metabolic acidosis.
  • Alkali therapy should be used judiciously, with careful monitoring of blood bicarbonate levels.
  • Renal replacement therapy may be necessary in cases of severe renal failure or poisoning.

References

[1] Context 1 [2] Context 2 [3] Context 3 [4] Context 5 [5] Context 8

Recommended Medications

  • Nutritional Therapy
  • Renal Replacement Therapy
  • Alkali Therapy

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Metabolic acidosis is a condition characterized by an excess of acid or a deficiency of bicarbonate in the body fluids, leading to a decrease in blood pH. The differential diagnosis of metabolic acidosis involves identifying the underlying cause of this condition.

Causes of Metabolic Acidosis

According to various sources [1-

Additional Information

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