Causes and Clinical Features of Metabolic Acidosis

Lactic Acidosis and Ketoacidosis: Mechanisms and Impact

Metabolic acidosis is a condition characterized by an abnormal accumulation of acid in the body, leading to a decreased blood pH. Two primary types—lactic acidosis and ketoacidosis—are clinically significant due to their pathophysiology and impact on patient health.

Causes of Metabolic Acidosis

• Lactic Acidosis: Caused by tissue hypoxia, sepsis, or excessive exertion leading to anaerobic metabolism.
• Ketoacidosis: Associated with uncontrolled diabetes mellitus, prolonged fasting, or alcoholism.
• Renal Failure: Impaired acid excretion due to kidney dysfunction.
• Toxin Ingestion: Methanol or ethylene glycol poisoning.

Clinical Features

Patients with metabolic acidosis may present with symptoms such as:

• Deep, rapid breathing (Kussmaul respiration).
• Confusion or altered mental status.
• Fatigue and muscle weakness.
• Cardiovascular instability in severe cases.

Diagnosis and Management

Diagnosis involves arterial blood gas analysis showing a decreased pH and bicarbonate levels. Management depends on the underlying cause, such as insulin therapy for ketoacidosis or bicarbonate replacement in severe cases.