In this AudioBrick from the Renal collection, we explore metabolic acidosis and alkalosis.  The normal pH of the blood falls within a pretty narrow range (7.35-7.45). Anything outside that range—whether acidotic or alkalotic—can lead to serious problems and even death. These abnormal pH states, called acid-base disorders, are grouped into two big categories: those that are caused by abnormal amounts of acid or base in the blood (metabolic acid-base disorders) and those that are caused by abnormal amounts of carbon dioxide in the blood (respiratory acid-base disorders). Respiratory acid-base disorders are discussed in a separate brick; here, we will focus on metabolic acid-base disorders.

After listening, you should be able to:

Define metabolic acidosis and alkalosis.

Describe the normal serum anion gap and why it might increase.

Describe the pathophysiology and common causes of metabolic acidosis with a high serum anion gap and with a normal anion gap.

Outline how to diagnose and treat metabolic acidosis.

Describe the pathophysiology and common causes of chloride-responsive metabolic alkalosis and chloride-resistant metabolic alkalosis.

Outline how to diagnose and treat metabolic alkalosis.

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