Metabolic acidosis (synonyms: Acidosis, metabolic; Acidosis; ICD-10-GM E87.2: Acidosis: metabolic) is characterized by a decrease in serum bicarbonate, a secondary decrease in CO2 partial pressure, and a reduction in blood pH below 7.36. Organic acids in the organism increase due to a metabolic disorder. It is also called hyperacidity of blood and body.
Metabolic acidosis is the most common acid-base balance disorder. It can occur acutely (a few minutes to a few days), e.g. in intensive care patients, or chronically (weeks to years), e.g. with declining kidney function.
Metabolic acidosis results from loss of bicarbonate or the intake of strong acid.
The most common form of metabolic acidosis is diabetic ketoacidosis, which occurs in poorly controlled diabetics (type 1): as a result of insulin deficiency, the diabetic is only able to obtain energy from glucose (monosaccharide/simple sugar) to a limited extent, if at all, and therefore burns more fatty acids. As a by-product of fat burning, so-called ketone bodies are formed, which bind large amounts of bicarbonate buffer. A relative deficiency of bicarbonate develops, leading to acidosis of the blood. This process is counteracted by the administration of insulin.
Course and Prognosis: The body compensates for metabolic acidosis by hyperventilation (increased ventilation of the respiratory tract (breathing apparatus) during respiration). CO2 is thus removed from the lungs and the pH of the blood rises again. However, there are limits to this possibility of compensation. The focus is on therapy of the underlying disease. In cases of severe acidosis, buffer substances such as sodium hydrogencarbont are administered. Metabolic acidosis becomes threatening when the pH falls below 7.15.
