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Your blood needs the right balance of acidic and basic (alkaline) compounds to function properly. This is called the acid-base balance. Your kidneys and lungs work to maintain the acid-base balance. Even slight variations from the normal range can have significant effects on your vital organs.
Acid and alkaline levels are measured on a pH scale. An increase in acidity causes pH levels to fall. An increase in alkaline causes pH levels to rise.
When the levels of acid in your blood are too high, it’s called acidosis. When your blood is too alkaline, it is called alkalosis.
Respiratory acidosis and alkalosis are due to a problem with the lungs. Metabolic acidosis and alkalosis are due to a problem with the kidneys.
Each of these conditions is caused by an underlying disease or disorder. Treatment depends on the cause.
When you breathe, your lungs remove excess carbon dioxide from your body. When they cannot do so, your blood and other fluids become too acidic.
Symptoms may include fatigue, shortness of breath, and confusion.
There are several different causes of respiratory acidosis including:
There are no noticeable symptoms of chronic respiratory acidosis. This is due to the fact that your blood slowly becomes acidic and your kidneys adjust to compensate, returning your blood to a normal pH balance.
Acute respiratory acidosis comes on suddenly, leaving the kidneys no time to adjust. Those with chronic respiratory acidosis may experience acute respiratory acidosis due to another illness that causes the condition to worsen.
A complete physical examination is necessary. Diagnostic testing may include:
A doctor should be seen immediately to treat acute respiratory acidosis, as this can be a life threatening condition. Treatment is targeted to the cause.
Bronchodilator medications may be given to correct some forms of airway obstruction. If your blood oxygen level is too low, you may require oxygen. Noninvasive positive pressure ventilation or a breathing machine may be necessary.
To treat chronic respiratory acidosis, the underlying cause needs to be determined in order for proper treatment to take place. The cause could be from an organ deformity, an infection, or some type of inflammation. Each cause may require a different treatment ranging from antibiotics to a breathing machine.
In either case, if you smoke, you will be advised to stop.
Complications of respiratory acidosisRespiratory acidosis is serious and requires immediate medical attention. Potential complications of untreated respiratory acidosis include respiratory failure, organ failure, and shock.
You can take steps to help prevent some of the conditions that lead to respiratory acidosis. Maintain a healthy weight. Take sedatives only under strict doctor supervision and never combine them with alcohol. Do not smoke.
Metabolic acidosis occurs either when your body produces too much acid, or when your kidneys are unable to remove it properly.
Symptoms of metabolic acidosis
There are three main types of metabolic acidosis. Diabetic acidosis, or diabetic ketoacidosis, is a buildup of ketone bodies. This is usually due to uncontrolled type 1 diabetes. Hyperchloremic acidosis is when your body loses too much sodium bicarbonate, often after severe diarrhea.
Lactic acidosis is when too much lactic acid builds up. This can be due to:
Diagnostic testing may include serum electrolytes, urine pH, and arterial blood gases. Once acidosis is confirmed, other tests may be necessary to pinpoint the cause.
The underlying condition behind the acidosis must be treated. In some cases, sodium bicarbonate is prescribed to return the blood to a normal pH.
Severe cases can lead to shock and can be life threatening.
Your blood is made up of acids and bases. The amount of acids and bases in your blood can be measured on a pH scale. It’s important to maintain the correct balance between acids and bases. Even a slight change can cause health problems. Normally, your blood should have a slightly higher amount of bases than acids.
Alkalosis occurs when your body has too many bases. It can occur due to decreased blood levels of carbon dioxide, which is an acid. It can also occur due to increased blood levels of bicarbonate, which is a base. This condition may also be related to other underlying health issues such as low potassium, or hypokalemia. The earlier it’s detected and treated, the better the outcome is.
There are four main types of alkalosis.
Respiratory alkalosis occurs when there isn’t enough carbon dioxide in your bloodstream. It’s often caused by:
Metabolic alkalosis develops when your body loses too much acid or gains too much base. This can be attributed to:
Hypochloremic alkalosis occurs when there’s a significant decline of chloride in your body. This can be due to prolonged vomiting or sweating. Chloride is an important chemical needed to maintain balance in bodily fluids, and it’s an essential part of your body’s digestive fluids.
Hypokalemic alkalosis occurs when your body lacks the normal amount of the mineral potassium. You normally get potassium from your food, but not eating enough of it is rarely the cause of a potassium deficiency. Kidney disease, excessive sweating, and diarrhea are just a few ways you can lose too much potassium. Potassium is essential to the proper functioning of the:
Symptoms of alkalosis can vary. In the early stages of the condition, you may have:
If alkalosis isn’t treated right away, severe symptoms can develop. These symptoms could lead to shock or coma. Call 911 or go to the nearest emergency room if you experience any of these symptoms:
The symptoms of alkalosis mimic symptoms of other conditions. It’s very important that you don’t attempt to diagnose yourself. Make an appointment with your doctor to get evaluated.
Your doctor will ask you about your medical history and the symptoms you’ve been experiencing. They will likely order tests that will rule out other conditions. Common tests include:
According to the American Association for Clinical Chemistry, normal blood pH levels are between 7.35 and 7.45. A blood pH above 7.45 may indicate alkalosis. Your doctor may also want to measure the carbon dioxide and oxygen levels in your blood to rule out respiratory issues.
Your treatment plan will depend on the cause of your alkalosis.
Your carbon dioxide level needs to return to normal if you have respiratory alkalosis. If you have rapid breathing caused by anxiety, taking slow, deep breaths can often improve symptoms and regulate your oxygen level. If tests reveal that you have a low oxygen level, you’ll need to receive oxygen through a mask.
If your rapid breathing is caused by pain, then treating the pain will help bring your respiratory rate back to normal and improve your symptoms.
If your alkalosis is caused by a loss of chemicals such as chloride or potassium, you’ll be prescribed medications or supplements to replace these chemicals.
Some cases of alkalosis result from an electrolyte imbalance, which may be corrected by drinking plenty of fluids or drinks that contain electrolytes. If you have an advanced case of electrolyte imbalance, it will need to be treated in the hospital.
Most people recover from alkalosis once they receive treatment.
Reduce your risk for developing alkalosis by maintaining good health, eating a healthy diet, and staying hydrated. Choosing foods high in nutrients and potassium can help combat electrolyte deficiencies. Nutrients and potassium are primarily found in fruits and vegetables, as well as some other foods, such as:
Steps you can take to prevent dehydration include:
It’s important to remember that you’re already dehydrated if you feel thirsty.
Dehydration can also occur rapidly if you lose a lot of electrolytes. This can happen when you’re vomiting from the flu. If you cannot keep potassium-rich foods in your stomach, make sure you still drink adequate fluids, such as water, sports drinks, and broth-based soups.
Dr Sushrut Fuladi is a well-known Consultant Nephrologist and Renal Transplant Physician with expertise in treating patients of Acute Kidney Injury, Chronic Kidney Disease, Hypertension and Diabetes related renal disorders, and renal replacement therapies.
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