- Michael Emmett, MD
Michael Emmett, MD
- Editor-in-Chief — Nephrology
- Section Editor — Fluid and Electrolytes
- Chief of Internal Medicine
- Baylor University Medical Center
D-lactic acidosis is an unusual form of lactic acidosis that can occur in patients with short bowel syndrome. It has also been described in patients who receive or ingest large amounts of propylene glycol and in patients with diabetic ketoacidosis. D-lactic acid is the stereoisomer of L-lactic acid, which is the principal isomer produced by humans and the acid responsible for lactic acidosis.
The pathogenesis, clinical manifestations, diagnosis, and treatment of D-lactic acidosis are presented here. The causes, diagnosis, and treatment of lactic acidosis (ie, L-lactic acidosis) are discussed separately. (See "Causes of lactic acidosis" and "Approach to the adult with metabolic acidosis" and "Bicarbonate therapy in lactic acidosis".)
Accumulation of D-lactic acid occurs primarily in three settings:
●In a patient with short bowel syndrome after consumption of a carbohydrate load
●In a patient who receives or ingests a large amount of propylene glycol
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