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Acid-base balance in the human body: Why is metabolic acidosis a health crisis?
Metabolic acidosis is a severe electrolyte imbalance characterized by a disturbance in the body's acid-base balance, resulting from three fundamental causes: excessive acid production, loss of bicarbonate, and the inability of the kidneys to effectively eliminate excess of acid. When the acidity in the body is too high, even if the pH value does not necessarily drop significantly in some cases, when the pH value is lower than 7.35, it is defined as acidemia. When dealing with metabolic acidosis, it is crucial to understand its impact on health.
Metabolic acidosis can present with diverse clinical symptoms and may affect everything from the cardiovascular system to muscles and bones.
Types and symptoms of metabolic acidosis
Acute metabolic acidosis
The symptoms of acute metabolic acidosis are often nonspecific, and diagnosis is often difficult. Possible symptoms include heart palpitations, headaches, changes in mental status (such as anxiety caused by lack of oxygen), vision loss, nausea, vomiting, abdominal pain, changes in appetite, and weight gain. At this point, the patient may develop rapid, deep breathing known as Kussmaul's breathing, which is one of the features associated with diabetic ketoacidosis.
Chronic metabolic acidosis
Unlike acute metabolic acidosis, the symptoms of chronic metabolic acidosis are also nonspecific, but it can be diagnosed by testing serum bicarbonate levels in patients with chronic kidney disease. Patients with chronic kidney disease should be regularly screened for metabolic acidosis to stay on top of related health conditions.
Diagnostic methods and causes
Metabolic acidosis usually occurs due to excessive acid production, loss of bicarbonate in the blood, or incomplete acid excretion of the kidneys. Acute metabolic acidosis is common in critically ill hospitalized patients, while chronic metabolic acidosis may be associated with chronic kidney disease.
The high mortality rate (up to 57%) in acute metabolic acidosis is often associated with untreated low pH (<7.20).
Dangers of metabolic acidosis
Acute metabolic acidosis can affect cardiovascular function and, in severe cases, can lead to dysfunction of multiple organs; while chronic metabolic acidosis has been shown to have a negative impact on bones and muscles and accelerate the deterioration of kidney function. Research results show that metabolic acidosis can lead to a decrease in bone density, increase the risk of fractures, and cause muscle atrophy and weakening.
Treatment methods
Treatment of metabolic acidosis begins with identifying its underlying cause. In acute situations, sodium bicarbonate therapy should be considered on a patient-specific basis. However, in patients with chronic kidney disease, the goal of treating metabolic acidosis is to slow the progression of the disease and reduce the risk of developing kidney failure. Dietary intervention and oral sodium bicarbonate have been shown to be effective in increasing serum bicarbonate levels.
For chronic metabolic acidosis, Veverimer (TRC 101) is a promising investigational drug that can effectively correct metabolic acidosis in the short term and improve body function.
Challenges and Reflections on Public Health
The impact of metabolic acidosis is not limited to personal health problems, but also a major challenge to the public health system. As chronic diseases increase, the healthcare system will need more careful management and understanding of acid-base balance to prepare for the coming health crisis. This is not only the responsibility of the individual himself, but also the need of the entire society.
Have you ever thought about how important maintaining acid-base balance in your body affects your daily life?
