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Chronic metabolic acidosis: Why is it often overlooked and so dangerous?
Chronic metabolic acidosis is a serious electrolyte imbalance characterized by an imbalance in the body's acid-base balance.It has three main sources: increased acid production, loss of bicarbonate and a reduced ability of the kidney to eliminate excessive acid.If left unattended, this acidosis can cause acidemia, which is defined as arterial plasma pH below 7.35.Acidemia and acidosis are not mutually exclusive, because pH and hydrogen ion concentrations are also affected by other acid-base imbalances.
Chronic metabolic acidosis can cause many health problems, including cardiovascular disease, bone and muscle decline.
Symptoms of acute metabolic acidosis
The symptoms of acute metabolic acidosis are not specific and the diagnosis is difficult, especially if the patient does not state clearly that blood gas analysis is required.Possible symptoms include: palpitations, headaches, changes in consciousness, high anxiety, decreased vision, nausea, vomiting, abdominal pain, appetite changes, and muscle weakness.
In the case of acute acidosis, patients may experience deep and rapid breathing, a type of Kussmaul breathing that is often associated with diabetic ketoacidosis.
Extreme acidemia can lead to neurological and heart complications, including lethargy, coma, epilepsy and abnormal heart rhythm, all of which need to be taken seriously.
The effects of chronic metabolic acidosis
The effects of chronic metabolic acidosis on the body are significant, especially in patients with chronic kidney disease (CKD).Studies have shown that if patients with CKD check their bicarbonate levels irregularly, it may lead to the continued worsening of metabolic acidosis and increase the risk of complications.
The main consequence of chronic metabolic acidosis is the negative impact on bones and muscles, which may lead to decreased bone density and increase the risk of fractures.
Diagnosis and causes
The diagnosis of metabolic acidosis depends on the measurement of bicarbonate in the serum, which usually has a concentration below 22 mEq/L.There are many causes of metabolic acidosis, including lactic acidosis, ketoacidosis, and chronic renal insufficiency.These factors can cause the body to produce excessive acid or lose enough bicarbonate.
The decrease in renal function makes the renal tubules unable to adequately eliminate excess acid, which causes the bicarbonate in the serum to be consumed by buffering acidic substances.
Treatment
The key to treating metabolic acidosis is to deal with its root cause.In response to acute metabolic acidosis, bicarbonate treatment is usually performed in severe cases with a pH below 7.1.According to the BICAR-ICU trial, bicarbonate treatment has potential benefits for improving the prognosis of patients with renal insufficiency.
Chronic metabolic acidosis needs to be managed through a low-protein diet and carbonate supplementation, which can delay the progression of chronic kidney disease.
Chronic metabolic acidosis warns people
The emergence of chronic metabolic acidosis is often overlooked, but its potential health risks cannot be underestimated.Although the symptoms of metabolic acidosis may not be obvious, irregular health checks may lead to worsening of the condition and even affecting general health.With the prevalence of chronic kidney disease, the understanding and attention to such diseases has become increasingly important.
Should I start paying attention to my acid-base equilibrium state to prevent potential health problems?
