How is metabolic acidosis diagnosed?

Updated: Oct 10, 2018
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

The only definitive way to diagnose metabolic acidosis is by simultaneous measurement of serum electrolytes and arterial blood gases (ABGs), which shows both pH and PaCO2 to be low; calculated HCO3- also is low. (See Metabolic Alkalosis for a discussion of the difference between measured and calculated HCO3- concentrations.)

A normal serum HCO3- level does not rule out the presence of metabolic acidosis, because a drop in HCO3- from a high baseline (ie, preexisting metabolic alkalosis) can result in a serum HCO3- level that is within the reference range, concealing the metabolic acidosis.


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