Metabolic acidosis: pathophysiology, diagnosis and management

Derangements in the intermediate metabolism of nutrients can lead to organic acid acidoses, which in turn can have severe clinical consequences that include even the patient's death. Lactic acidosis and ketoacidosis represent the most relevant clinical forms of this type of metabolic acidosis. Assessment and proper management of the organic acid acidoses require the intervention of a skillful clinician that balances the potential benefits and risks of the prescribed measures to the specific needs of the individual patient. To this aim, knowledge of the pathophysiology, diagnosis, and therapy of the various forms of acidoses including alkali administration, represent essential requirements.