4- Anion exchange (CL- versus HCo 3 - ) as with the use of
cholestyramine.
5- Ingestion of Ca and Mg chlorides.Treatment of metabolic acidosis:
1- Treatment of the cause and compensate for the deficit
2- In distal RTA, NaHCo 3 should be provided 1-3 mmol/kg/d, sometimes
K+ supplementation is required. In children NaHCo 3 will be provided
in a dose of 5-15 mmol/kg/d.
3- In proximal RTA large amounts of alkali are provided (10-25
mmol/kg/d) and K+ supplementation.
Respiratory Acidosis
In respiratory acidosis, Co 2 retention occurs and the reaction (Co 2
- H 2 O ∅ H 2 Co 3 × H+ + HCo 3 - )^ results in accumulation of H+ in
circulation and acidosis. The kidney compensates by the secretion of H+
and reabsorption of HCo 3 -.^
In acute respiratory acidosis blood Hco 3 - increases by 1 mmol/L
for every 10 mmHg increase in PCo 2 while in chronic respiratory acidosis
HCo 3 - increases by 3.5 mmol for very 10 mmHg increase in PCo 2.
Features of respiratory acidosis:
- high PCo 2
- low pH
- high HCo 3 -
- urine pH is low <5.4
Etiology: