Mild acidosis in adults with bicarb > 20 mEq/L may not require treatment
Children should be treated due to impaired growth
For type I and II<unk> , treat all children and infants
Generally, 5-15 mEq/kg/day oral bicarbonate
May require IV bicarbonate for severe acidosis
PO potassium supplements
Treat adults with bicarb < 18-20 mEq/L
Treat underlying d/o (Vitamin D, etc.)
Generally, 5-15 mEq/kg/day oral bicarbonate
May require IV bicarbonate for severe acidosis
PO potassium supplements
Treat adults with bicarb < 18-20 mEq/L
Treat underlying d/o (Vitamin D, etc.)
Type II<unk>  - reduced bicarbonate reabsorption
Hypokalemia
Serum bicarb 12-20 mEq/L generally
Urine pH < 5.5, but can be variable
Urine pH > 5.5 if undergoing alkali therapy
Hypokalemia
Serum bicarb 12-20 mEq/L generally
Urine pH < 5.5, but can be variable
Type I<unk>  - impaired H+ and ammonium secretion
Hypokalemia
Normokalemia may be seen in chronic interstitial<unk>  disease
Serum bicarb may be < 10 mEq/L
Urine pH > 5.5
Urinary anion gap > 50 mEq/L = Na + K - Cl
Nephrolithiasis, calcium stones from chronic acidosis causing bone resorption and hypercalciuria
Hypokalemia
Normokalemia may be seen in chronic interstitial<unk>  disease
Serum bicarb may be < 10 mEq/L
Urine pH > 5.5
Urinary anion gap > 50 mEq/L = Na + K - Cl
Nephrolithiasis, calcium stones from chronic acidosis causing bone resorption and hypercalciuria
Normokalemia may be seen in chronic interstitial<unk>  disease
Also distal<unk>  acidosis
Hyperkalemia
Mild acidosis, with bicarb generally > 17 mEq/L
Urine pH < 5.5
Serum aldosterone and cortisol levels to determine between:
Adrenal insufficiency, Addison's (low aldosterone, low cortisol)
Selective aldosterone deficiency (low aldosterone, normal cortisol)
Aldosterone resistance (nl to high aldosterone, nl to high cortisol)
Hyperkalemia
Mild acidosis, with bicarb generally > 17 mEq/L
Urine pH < 5.5
Adrenal insufficiency, Addison's (low aldosterone, low cortisol)
Selective aldosterone deficiency (low aldosterone, normal cortisol)
Aldosterone resistance (nl to high aldosterone, nl to high cortisol)
Renal tubular acidosis
See metabolic acidosis
Dialysis-associated hypotension
Anion gap acidosis
Dehydration
Dehydration 
Hyperosmolar hyperglycemic state
Dialysis disequilibrium syndrome