Metabolic acidosis

When metabolic acidosis is known in medicine metabolic acidosis of the blood and the body ( acidosis). It is caused by increases in body metabolism resulting protons, which decreased excretion or bicarbonate loss.

Causes

( Not caused by chronic malnutrition provided ) The most common causes of metabolic acidosis are

• Chronic renal failure with uremia or distal tubular acidosis with insulated tubular H Sekretionsdefekt the kidneys ( Retentionsazidose )
• Diabetic metabolic decompensation with ketoacidosis at the absolute lack of insulin, lactic acidosis (both Additionsazidosen - increased anion gap ),
• Poisoning with acidic substances, such as acetylsalicylic acid, the active ingredient in Aspirin (also a Additionsazidose )
• Loss of bicarbonate ions in the proximal tubule or diarrhea ( Subtraktionsazidose ).

The most common metabolic acidosis, diabetic ketoacidosis: The Diabetic wins in insulin deficiency, as it can utilize no glucose, energy through increased oxidation of fatty acids. This increased fat loss incurred ketone bodies, bind large amounts of bicarbonate buffer. The resulting relative lack of bicarbonate leads to acidification of the blood.

Diagnosis

A patient with metabolic acidosis striking on account of its enhanced, deep, normofrequent breathing (so called Kussmaul breathing ). In diabetic ketoacidosis, you can usually also notice a fruity odor of acetone in the breath. Critical to the detection and quantification of metabolic acidosis is the blood-gas analysis. From the base deficit, the pH and the CO2 partial pressure, the degree of metabolic acidosis and the degree of respiratory compensation of the body can easily recognize. Next differentiate can be the causes using the anion gap.

Therapy

Therapeutic treatment is the cause in the foreground. By administering insulin can, for example, in diabetic ketoacidosis very fast improvement can be achieved. Note this is also the sufficient fluid and electrolyte intake. In uremia, dialysis must be sought. Through the administration of sodium bicarbonate or other buffers can try to limit the metabolic derangement of metabolic acidosis, at least temporarily. However, this is done due to serious drawbacks, such as electrolyte imbalance only in severe acidosis with a pH < 7.1.