A to Z Health Guide

Metabolic Acidosis: Resources for Patients

What do you know about metabolic acidosis and chronic kidney disease?

This short quiz can help you understand why people with CKD have increased risk for metabolic acidosis, and why and how metabolic acidosis makes kidney disease worse.

Take a short quiz
Want to learn the basics of metabolic acidosis?

Check out the Metabolic Acidosis A-to-Z page.

Facts about Metabolic Acidosis

The fact sheet contains interesting facts and statistics about metabolic acidosis and CKD.


The infographics below explain metabolic acidosis, illustrating why and how metabolic acidosis happens in CKD, the health problems it causes, and how it makes CKD worse.

Damaged kidneys can't get rid of extra acid in the body.

A diet high in animal-based proteins like red meat and low in fruits and vegetables increases acid in the body.

Acid builds up in the blood.

Metabolic Acidosis

Serum bicarbonate is low and shows up on a lab test as low CO2 (carbon dioxide) in the blood (less than 22 mEq/L).


  • Weakness
  • Fatigue easily
  • Trouble breathing
  • Headache
  • Mental confusion
  • Fast heartbeat
  • Loss of appetite
  • Nausea and vomiting
  • You may not have any symptoms

Long-Term Problems

  • Bone loss
  • Muscle loss
  • Hormone problems that cause high blood sugar and stop growth in children
  • Chronic Kidney Disease gets worse

Metabolic Acidosis & Chronic Kidney Disease

(too much acid in the body)


Blood bicarbonate below 22 mEq/L

Target Blood Bicarbonate

24 to 26 mEq/L

Treatments to Lower Acid*

Diet high in fruts and vegetables
Daily Servings
Whole Grains
Low fat milk
Lean meats, poultry,
and fish
6 oz or less
Nut, seeds, and
4-5 per week
Examples: sodium bicarbonate, sodium citrate
*You should consult your healthcare team before making dietary changes or taking medicines for metabolic acidosis.
** The DASH diet is high in potassium

What factors predict your level of risk for developing kidney failure and what can you do to reduce some of that risk?

Find information here about the risk factors for developing kidney failure and how to reduce that risk. Learn about metabolic acidosis is explained, and why its treatment is integral to achieving the overall goal of slowing the progression of CKD and preventing or delaying the onset of kidney failure. Link to Resources

There’s also an app called Neph + that calculates your individual risk for developing kidney failure within the next 2 year and 5-year periods. This app also contains information on metabolic acidosis and other risk factors for kidney failure, along with guidance on how you can reduce those risks.

Get information on how to download the new Neph+ App on your Android or iOS device.

Neph+ for iOS

Neph+ for Android

Additional Resources

Information about the lab test used to diagnose and monitor metabolic acidosis
Link to Information

Plant-based diets for helping to prevent or improve metabolic acidosis
Link to Plant-based Diets