Many of the systems in the body create acids. The amount of these acids in your bloodstream is usually regulated by the kidneys, which flush out the appropriate amount of acid with your urine. When your kidneys aren’t working at capacity, the acids can build up, resulting in an imbalance called metabolic acidosis. The National Kidney Foundation provides a brief introduction to this condition.*

How do I know if I have metabolic acidosis?

Not everyone with metabolic acidosis notices signs or experiences symptoms.

Those who do have reported:

• rapid heartbeat,
• shallow breathing,
• fatigue,
• headache,
• confusion,
• weakness,
• nausea,
• vomiting, and/or
• loss of appetite.

Contact your doctor immediately if you experience one or more of the symptoms listed above. 

What other effects can metabolic acidosis have on my health?

Metabolic acidosis can further complicate your kidney disease in several ways, including:

• Bone loss: Bone loss makes your bones porous and weak, leaving them more vulnerable to breaks and fractures.
• Muscle loss: Muscle health is maintained by proteins in the body, such as albumin. Metabolic acidosis hinders the production of albumin, leading to muscle loss, also called “muscle wasting.”
• Faster disease progression: Weakened kidneys can lead to acid buildup, and acid buildup increases the damage to your kidneys. 
• Hormone imbalances: Metabolic acidosis also impairs the functions performed by your endocrine (hormone production) system. This interference can result in resistance to insulin, a hormone that regulates your blood sugar level. A blood sugar imbalance can lead to diabetes if left untreated.

How is metabolic acidosis diagnosed and treated?

Metabolic acidosis is generally diagnosed with a series of blood tests and a urine sample to check your kidney function and the levels of acids and bases in your blood. Low bicarbonate levels, in particular, are an indicator of metabolic acidosis. 

Bicarbonate is a form of carbon dioxide that is naturally produced in the body. It helps balance the level of acids in your blood, and healthy kidneys help balance your level of bicarbonate. Unhealthy kidneys hamper that process.

Low bicarbonate levels can also cause your kidney disease to progress. Several studies have suggested that treatment with either sodium bicarbonate or sodium citrate can help, but taking either is not recommended without a prescription from your doctor.

*National Kidney Foundation. (2020). Metabolic Acidosis.