What is the pathogenesis of alcoholic ketoacidosis (AKA)?

Updated: Aug 27, 2020
  • Author: George Ansstas, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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The pathogenesis of AKA is complex. [14] Although the general physiological factors and mechanisms leading to AKA are understood, the precise factors have not been fully elucidated. The following are the 3 main predisposing events:

  • Delay and decrease in insulin secretion and excess glucagon secretion, induced by starvation and counter-regulatory hormones

  • Elevated ratio of the reduced form of nicotinamide adenine dinucleotide (NADH) to nicotinamide adenine dinucleotide (NAD+) secondary to alcohol metabolism

  • Volume depletion resulting from vomiting and poor oral intake of fluids

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