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Metabolic Acidosis Nondiabetic

Arch Intern Med. 1965;116(5):717-728. doi:10.1001/archinte.1965.03870050071011.
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Introduction  METABOLIC acidosis may be defined as an excess of arterial blood hydrogen ion not caused by an increase in carbonic acid. This excess of hydrogen ion can be brought about in two basic ways:

  1. Increase in strong acids in the body. This can be endogenous as with the increase in β-OH-butyric acid and acetoacetic acid in starvation ketosis or exogenous as with NH4Cl administration.

  2. Loss of bicarbonate from the body, ie, diarrhea, from the kidneys, etc.

One of the buffer systems affected is the following:Addition of strong acids to the body will force this reaction to the right and the excess CO2 formed will be eliminated by the lungs. The result will be a lowered bicarbonate and relative excess of hydrogen ion. Loss of bicarbonate from the body will drive the reaction to the left and also result in a lowered bicarbonate and an excess of


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