Section XI/Chapter 119/ACID-BASE DISORDERS from Cecil Medicine

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Thus, respiratory acidosis is nearly always a consequence of decreased pulmonary ventilation from lung or central nervous system (CNS) disease rather than only increased production of CO₂. Respiratory alkalosis develops from hyperventilation rather than decreased CO₂production. In either case, when the elimination rate of CO₂ (the product of    a × Pco₂) again equals CO₂ production, a new steady state will prevail with no net carbonic acid retention or loss.

In metabolic disorders, if metabolic production of acid exceeds elimination, a state of metabolic acidosis exists, whereas if elimination exceeds production, metabolic alkalosis will develop. In the case of metabolic acidosis, production could exceed excretion via a marked excess in the production rate, as might be seen with diabetic ketoacidosis (DKA) or lactic acidosis, or it could develop even with a normal rate of metabolic acid production if the kidney were unable to eliminate acid normally, as in kidney failure.