Metabolic acidosis causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Overview

Metabolic acidosis is a state in which the blood pH is low (less than 7.35) due to an increased blood concentration of H+.

Causes

Life Threatening Causes

Common Causes

Normal Anion Gap (Hyperchloremic Acidosis)

The mnemonic for the most common causes of a normal-anion gap metabolic acidosis is "DURHAM."

High Anion Gap

The mnemonic "MUDPILES" is used to remember the causes of a high anion gap.

Causes by Organ System

Cardiovascular Aortic arch interruption, Fanconi-Albertini-Zellweger syndrome, hypoplastic left heart syndrome, shock
Chemical / poisoning aldicarb, 4-aminopyridine, ammonium bifluoride, ammonium chloride, aristolochic acid , borates, bromophos, carbaryl, chloralose, chlorfenvinphos, chlorpyrifos, cleistanthus collinus, clove, coumaphos, cyanides, demeton-S-methyl, diazinon, 1,2-Dibromoethane, dichlorvos, dicrotophos, dinitrophenol, dioxathion, disulfoton, ethanol, ethion, ethylene glycol, fensulfothion, fenthion, glycol ether, glyphosate, imazapyr, iron compounds, iobenguane I 123,malathion, margosa oil, metaldehyde, methanol, methidathion, methiocarb, methomyl, monochloroacetate, parathion, phenol, phosdrin, polyethylene glycol , profenofos, propoxur, propylene glycol, pyrimidifen, salicylate poisoning, strychnine, terbufos, tetraethyl pyrophosphate, toluene, toxic mushrooms , triethylene glycol, tungsten
Dermatologic No underlying causes
Drug Side Effect Abacavir, Acetaminophen and Oxycodone, acetazolamide, amitriptyline, amlodipine, amoxapine, amphotericin B, aspirin, cholestyramine, clomipramine, clove, cocaine, desipramine, didanosine, doxepin, emtricitabine, felodipine , formoterol, imipramine, isoniazid, isradipine, Ixabepilone, Mafenide, malignant hyperpyrexia, malignant hyperthermia, metformin, neuroleptic malignant syndrome, nifedipine, nimodipine, nitroprusside, nortriptyline, Oxaliplatin, paracetamol, phenformin, Potassium chloride, protriptyline, Reye's syndrome, salicylate poisoning, stavudine, topiramate, trimipramine
Ear Nose Throat No underlying causes
Endocrine Adrenal cortex insufficiency, 17- beta-hydroxysteroid dehydrogenase deficiency, diabetes, diabetic ketoacidosis, glucocorticoid resistance, hyperosmolar non-ketotic diabetic coma, hypoaldosteronism, lipoid congenital adrenal hyperplasia, pseudohypoaldosteronism, VIPoma
Environmental No underlying causes
Gastroenterologic Acute liver failure, bacterial overgrowth of small intestine, biliary fistula, congenital chloride diarrhea, diarrhea, duodenal atresia, GI HCO3- loss, hepatic failure, intestinal fistulas, intestinal ischaemia, lactose intolerance, necrotizing enterocolitis, pancreatic fistula, VIPoma
Genetic 17- beta-hydroxysteroid dehydrogenase deficiency, biotinidase deficiency, coenzyme Q10 deficiency, congenital chloride diarrhea, cystinosis, dihydrolipoamide dehydrogenase deficiency, fructose-1, 6-diphosphatase deficiency, ethylmalonic encephalopathy, Fanconi-Albertini-Zellweger syndrome, fructose-1-phosphate aldolase deficiency, galactosemia, glucose transporter type 1 deficiency, glutaric aciduria, glutathione synthetase deficiency, glycerol kinase deficiency, glycogenosis, GRACILE syndrome, Hawkinsinuria, hepatocerebral form of mitochondrial DNA depletion syndrome, HMG-CoA lyase deficiency, holocarboxylase synthase deficiency, 3-hydroxyacyl-coenzyme A dehydrogenase deficiency, 3 hydroxyisobutyric aciduria, isovaleric acidaemia, lipoid congenital adrenal hyperplasia, long chain hydroxyacyl-CoA dehydrogenase deficiency, Lowe syndrome, Lutz-Richner and Landolt syndrome, malignant hyperpyrexia, malignant hyperthermia, malonyl-CoA decarboxylase deficiency, maple syrup urine disease, medium chain acyl-CoA dehydrogenase deficiency, medullary cystic kidney disease, MELAS, MERRF, 3-methylcrotonyl-CoA carboxylase deficiency, 3-methylglutaconic aciduria, methylmalonic acidemia, microcephaly, Amish type, mitochondrial acetoacetyl-CoA thiolase deficiency, mitochondrial aspartyl-tRNA synthetase deficiency, molybdenum cofactor deficiency, myopathy with deficiency of succinate dehydrogenase and aconitase, nephronophthisis, osteopetrosis with renal tubular acidosis, phosphoglucomutase deficiency, propionic acidemia, propionyl-CoA carboxylase deficiency, pseudohypoaldosteronism, pyruvate carboxylase deficiency, pyruvate dehydrogenase deficiency, Senior-Loken syndrome, short-chain acyl-coenzyme A dehydrogenase deficiency, succinyl-CoA acetoacetate transferase deficiency, succinyl-CoA synthetase deficiency, vitamin B12-responsive methylmalonic acidemia
Hematologic Myeloma
Iatrogenic Hyperalimentation, malignant hyperpyrexia, malignant hyperthermia, Reye's syndrome, short bowel syndrome, ureteral diversion, ureterosigmoidostomy
Infectious Disease No underlying causes
Musculoskeletal / Ortho Myopathy with deficiency of succinate dehydrogenase and aconitase, osteopetrosis with renal tubular acidosis
Neurologic Leigh syndrome, Lowe Syndrome, microcephaly, Amish type
Nutritional / Metabolic 17- beta-hydroxysteroid dehydrogenase deficiency, biotinidase deficiency, coenzyme Q10 deficiency, cystinosis, diabetic ketoacidosis, dihydrolipoamide dehydrogenase deficiency, fructose-1, 6-diphosphatase deficiency, ethylmalonic encephalopathy, Fanconi-Albertini-Zellweger syndrome, fructose-1-phosphate aldolase deficiency, galactosemia, glutaric aciduria, glutathione synthetase deficiency, glycerol kinase deficiency, glycogenosis, Hawkinsinuria, HMG-CoA lyase deficiency, holocarboxylase synthase deficiency, 3-hydroxyacyl-coenzyme A dehydrogenase deficiency, 3 hydroxyisobutyric aciduria, Hyperkalaemia, hyperosmolar non-ketotic diabetic coma, hypoalbuminism, isovaleric acidaemia, ketoacidosis, lactic acidosis, Leigh syndrome, long chain hydroxyacyl-CoA dehydrogenase deficiency, malonyl-CoA decarboxylase deficiency, maple syrup urine disease, medium chain acyl-CoA dehydrogenase deficiency, 3-methylcrotonyl-CoA carboxylase deficiency, 3-methylglutaconic aciduria, methylmalonic acidemia, mitochondrial acetoacetyl-CoA thiolase deficiency, molybdenum cofactor deficiency, myopathy with deficiency of succinate dehydrogenase and aconitase, organic acidemia, phosphoglucomutase deficiency, propionic acidemia, propionyl-CoA carboxylase deficiency, pyruvate carboxylase deficiency, pyruvate dehydrogenase deficiency, short-chain acyl-coenzyme A dehydrogenase deficiency, succinyl-CoA acetoacetate transferase deficiency, succinyl-CoA synthetase deficiency, vitamin B12-responsive methylmalonic acidemia
Obstetric/Gynecologic No underlying causes
Oncologic Myeloma
Opthalmologic Lowe syndrome, Senior-Loken syndrome
Overdose / Toxicity Abacavir, acetazolamide, amitriptyline, amlodipine, amoxapine, amphotericin B, aspirin, cholestyramine, clomipramine, clove, cocaine, desipramine, didanosine, doxepin, emtricitabine, felodipine , imipramine, isoniazid, isradipine, malignant hyperpyrexia, malignant hyperthermia, metformin, neuroleptic malignant syndrome, nifedipine, nimodipine, nitroprusside, nortriptyline, paracetamol, phenformin, protriptyline, Reye's syndrome, salicylate poisoning, stavudine, trimipramine
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte Acute renal failure, analgesic nephropathy syndrome, chronic interstitial nephritis, chronic renal failure, compensation in primary respiratory alkalosis, hypoaldosteronism, Lightwood Albright syndrome, Lowe syndrome, medullary cystic kidney disease, nephronophthisis, osteopetrosis with renal tubular acidosis, renal HCO3- loss, renal tubular acidosis, Senior-Loken syndrome, Ureteral diversion
Rheum / Immune / Allergy No underlying causes
Sexual 17- beta-hydroxysteroid dehydrogenase deficiency
Trauma No underlying causes
Urologic Ureteral diversion
Dental No underlying causes
Miscellaneous Cuffed blood sample, near-drowning, starvation

Causes in Alphabetical Order


References

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