Alkalosis
Alkalosis is a condition in which the body fluids have excess base (alkali).
Causes
The kidneys and lungs maintain the proper balance (proper pH level) of chemicals, called acids and
bases, in the body. Decreased carbon dioxide (an acid) or increased bicarbonate (a base) level
makes the body too alkaline, a condition called alkalosis. There are different types of alkalosis.
These are described below.
bases, in the body. Decreased carbon dioxide (an acid) or increased bicarbonate (a base) level
makes the body too alkaline, a condition called alkalosis. There are different types of alkalosis.
These are described below.
Respiratory alkalosis is caused by a low carbon dioxide levels in the blood. This can be due to:
- Fever
- Being at a high altitude
- Lack of oxygen
- Liver disease
- Lung disease, which causes you to breathe faster (hyperventilate)
- Salicylate poisoning
Metabolic alkalosis is caused by too much bicarbonate in the blood. It can also occur due to certain kidney diseases.
Hypochloremic alkalosis is caused by an extreme lack or loss of chloride, such as from prolonged vomiting.
Hypokalemic alkalosis is caused by the kidneys' response to an extreme lack or loss of potassium. This can occur from taking certain water pills (diuretics).
Compensated alkalosis occurs when the body returns the acid-base balance to normal in cases of alkalosis, but bicarbonate and carbon dioxide levels remain abnormal.
Symptoms
Symptoms of alkalosis can include any of the following:
- Confusion (can progress to stupor or coma)
- Hand tremor
- Light-headedness
- Muscle twitching
- Nausea, vomiting
- Numbness or tingling in the face, hands, or feet
- Prolonged muscle spasms (tetany)
Exams and Tests
The doctor will perform a physical exam and ask about your symptoms.
Laboratory tests that may be ordered include:
- Arterial blood gas analysis
- Electrolytes test, such as basic metabolic panel to confirm alkalosis and show whether it is respiratory or metabolic alkalosis.
Other tests may be needed to determine the cause of the alkalosis. These may include:
Treatment
To treat alkalosis, your health care provider needs to find the cause.
For alkalosis caused by hyperventilation, breathing into a paper bag allows you to keep more carbon dioxide in your body, which improves the alkalosis. If your oxygen level is low, you may receive oxygen.
Medicines may be needed to correct chemical loss (such as chloride and potassium). Your health care provider will monitor your vital signs (temperature, pulse, rate of breathing, blood pressure).
Outlook (Prognosis)
Most cases of alkalosis respond well to treatment.
Possible Complications
Untreated or not treated properly, complications may include any of the following:
- Arrhythmias
- Coma
- Electrolyte imbalance (such as hypokalemia)
When to Contact a Medical Professional
Call your health care provider if you become confused, unable to concentrate, or unable to "catch your breath."
Go to the emergency room or call the local emergency number (such as 911) if there is:
- Loss of consciousness
- Rapidly worsening symptoms of alkalosis
- Seizures
- Severe breathing difficulties
Prevention
Prevention depends on the cause of the alkalosis. Normally, people with healthy kidneys and lungs do not have serious alkalosis.
Metabolic acidosis
Metabolic acidosis is a condition in which there is too much acid in the body fluids.
Causes
Metabolic acidosis occurs when the body produces too much acid, or when the kidneys are not removing enough acid from the body.
There are several types of metabolic acidosis:
Diabetic acidosis (also called diabetic ketoacidosis and DKA): Develops when acidic substances known as ketone bodies, build up in the body. This occurs with uncontrolled type 1 diabetes
Hyperchloremic acidosis: Results from excessive loss of sodium bicarbonate from the body. This can occur with severe diarrhea
Lactic acidosis: Results from a buildup of lactic acid. It can be caused by:
- Alcohol
- Cancer
- Exercising intensely
- Liver failure
- Medications, such as salicylates
- Prolonged lack of oxygen from shock, heart failure, or severe anemia
- Seizures
Other causes of metabolic acidosis include:
- Kidney disease (distal renal tubular acidosis and proximal renal tubular acidosis)
- Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol
- Severe dehydration
Symptoms
Most symptoms are caused by the underlying disease or condition that is causing the metabolic acidosis. Metabolic acidosis itself usually causes rapid breathing. Confusion or lethargy may also occur. Severe metabolic acidosis can lead to shock or death. In some situations, metabolic acidosis can be a mild, chronic (ongoing) condition.
Exams and Tests
- Arterial blood gas
- Serum electrolytes
- Urine pH
Arterial blood gas analysis and a serum electrolytes test (such as a basic metabolic panel) will confirm acidosis is present and determine whether it is respiratory acidosis or metabolic acidosis.
Other test may be needed to determine the cause of the acidosis.
Treatment
Treatment is aimed at the underlying condition. In some cases, sodium bicarbonate (the chemical in baking soda) may be given to reduce the acidity of the blood.
Outlook (Prognosis)
The outlook will depend on the underlying disease causing the condition.
Possible Complications
Very severe metabolic acidosis can lead to shock or death.
When to Contact a Medical Professional
Seek medical help if you have symptoms of any disease that can cause metabolic acidosis.
Prevention
Diabetic ketoacidosis can be prevented by keeping type 1 diabetes under control.
Alternative Names
Acidosis - metabolic
