How does the body compensate for metabolic acidosis?

As blood pH drops (becomes more acidic), the parts of the brain that regulate breathing are stimulated to produce faster and deeper breathing (respiratory compensation). Breathing faster and deeper increases the amount of carbon dioxide exhaled. The kidneys also try to compensate by excreting more acid in the urine.

How do you compensate for metabolic acidosis?

Respiratory alkalosis results from hyperventilation as the primary disturbance. Hyperventilation also forms the respiratory compensation of metabolic acidosis. It is found that complete compensation of pH disturbances requires the kidney to change plasma [HCO3−].

What body system compensates for metabolic acidosis?

COMPENSATION OF RESPIRATORY AND METABOLIC ACIDOSIS OR ALKALOSIS. For compensation to occur, the renal and respiratory systems work together to regain and maintain a normal blood pH level.

How does metabolic compensation work?

Metabolic compensation (alkalosis): The body compensates for the decreased pH from the primary respiratory acidosis by increasing renal excretion of H+.

What causes compensated metabolic acidosis?

Acidemia (arterial pH < 7.35) results when acid load overwhelms respiratory compensation. Causes are classified by their effect on the anion gap (see table Causes of Metabolic Acidosis).

Causes of Metabolic Acidosis.

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Cause Examples
High anion gap
Ketoacidosis Alcohol (chronic abuse) Diabetes Fasting Undernutrition

What are three causes of metabolic acidosis?

Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. Metabolic acidosis can lead to acidemia, which is defined as arterial blood pH that is lower than 7.35.

When should metabolic acidosis be corrected?

Treatment of acute metabolic acidosis by alkali therapy is usually indicated to raise and maintain the plasma pH to greater than 7.20. In the following two circumstances this is particularly important. When the serum pH is below 7.20, a continued fall in the serum HCO3- level may result in a significant drop in pH.

How do you know if its metabolic acidosis or respiratory acidosis?

Metabolic acidosis: patients who are acidotic and have a HCO3– <22 (base excess <–2); Respiratory acidosis: patients who are acidotic with a PaCO2 >6; Metabolic alkalosis: patients who are alkalotic with a HCO3– >28 (base excess >+2); Respiratory alkalosis: patients who are alkalotic with a PaCO2 <4.7.

How do kidneys compensate for metabolic acidosis?

The renal response to metabolic acidosis is mediated, in part, by increased expression of the genes encoding key enzymes of glutamine catabolism and various ion transporters that contribute to the increased synthesis and excretion of ammonium ions and the net production and release of bicarbonate ions.

How long does metabolic compensation take?

Metabolic compensation for a respiratory alkalosis develops gradually and takes 2-3 days. In chronic compensation, plasma bicarbonate falls by 4 for each 10 mm Hg decrease in the Pco2.

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How do I know if I have respiratory or metabolic compensation?

Assume metabolic cause when respiratory is ruled out.

If PaCO2 is abnormal and pH is normal, it indicates compensation. pH > 7.4 would be a compensated alkalosis. pH < 7.4 would be a compensated acidosis.

How do you manage respiratory acidosis?


  1. Bronchodilator medicines and corticosteroids to reverse some types of airway obstruction.
  2. Noninvasive positive-pressure ventilation (sometimes called CPAP or BiPAP) or a breathing machine, if needed.
  3. Oxygen if the blood oxygen level is low.
  4. Treatment to stop smoking.


How serious is metabolic acidosis?

Metabolic acidosis itself most often causes rapid breathing. Acting confused or very tired may also occur. Severe metabolic acidosis can lead to shock or death. In some situations, metabolic acidosis can be a mild, ongoing (chronic) condition.

What is an example of metabolic acidosis?

Kidney disease (uremia, distal renal tubular acidosis or proximal renal tubular acidosis). Lactic acidosis. Poisoning by aspirin, ethylene glycol (found in antifreeze), or methanol. Severe dehydration.

How do you know if acidosis is compensated?

If the pH is not within or close to the normal ranges, then a partial-compensation exists. If the pH is back within normal ranges then a full-compensation has occurred. A non-compensated or uncompensated abnormality usually represents an acute change occurring in the body.

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