EM2002O "Chronic Metabolic Acidosis: Alkali Therapy ... Is There Anything Else?" (IM GR-022820)

Physicians are essentially human biologists and as such, should strive to understand organ function, and master the causes and effects of dysfunction, which are the roots of human disease. Knowledge of pathobiology is a critical and integral part of medicine. Unfortunately, a prevalent disconcerting trend is that we have replaced this philosophy with diagnostic and therapeutic algorithms that led, albeit unintentionally, to the continuous diminution of clinical pathophysiology. This lecture utilizes a common clinical condition, metabolic acidosis, as a vehicle to illustrate the inadequacy of conventional teaching that does not include understanding of mechanisms of disease.

Metabolic acidosis is a disorder resultant from increased acid production/addition, decreased excretion, or both. Each of the above have different underlying etiologies and pathophysiology, which should be identified by the clinician. The ill effects of acidosis and acid loading are often not generally appreciated by the practitioner. The treatment of chronic metabolic acidosis involves correction of the underlying pathophysiology and when such corrections are not possible, we prescribe alkali therapy.

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Target Audience

UT Southwestern faculty, fellows, residents and medical students, community physicians, nurse clinicians, physician assistants and nurses.

Learning Objectives

At the conclusion of this activity, the participant should be able to:

  • Know some clinical physiology on acid-base homeostasis
  • Appreciate the power of clinical chemistry as a window to pathophysiology
  • Be aware of the limitations of the common classifications and algorithms in evaluating metabolic acidosis
  • Know the difference between acid load and acidosis
  • Be cognizant of the multi-organ ill effects of chronic metabolic acidosis
Course summary
Available credit: 
  • 1.00 AMA
Course opens: 
Course expires: 

Photo: Orson Moe, M.D.Orson Moe, M.D.
Professor, Departments of Internal Medicine and Physiology
Director, Pak Center for Mineral Metabolism and Clinical Research
Division Chief, Nephrology

Orson Moe received his medical degree, residency, and nephrology fellowship from the University of Toronto. He trained in research in renal physiology at UTSW and subsequently joined the faculty in 1990. He has the administrative roles of the Director of the Charles and Jane Pak Center of Mineral Metabolism and Clinical Research and a member of the Nephrology Division. He is the holder of the Charles and Jane Pak Distinguished Chair in Mineral Metabolism Research and the Donald Seldin Professorship in Clinical Investigation. Moe conducts both basic science and patient-oriented research in epithelial biology, renal physiology, preclinical pathobiology, and mineral metabolism. He is editing Current Opinion in Nephrology and Hypertension, and the textbook Seldin and Giebiesch’s The Kidney: Physiology and Pathophysiology. He is a member of the American Society of Clinical Research, Association of American Physicians, American Society of Nephrology, International Society of Nephrology, and American Physiologic Society.

Available Credit

  • 1.00 AMA


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