What is metabolic acidosis in a CAPD dialysis patient?

Question
What is metabolic acidosis in a CAPD dialysis patient? How can I recognise it and what are the symptoms? What happens when the bicarbonates level is high/low in a CAPD dialysis patient?
Expert Answer
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Metabolic acidosis occurs in patients with kidney failure, as kidney is not able to excrete the acid generated by body metabolism. CAPD fluid provides lactate, which is converted to bicarbonate in the liver and corrects metabolic acidosis of kidney failure. Metabolic acidosis leads to breathing difficulty. On CAPD - serum carbonate should be between 20-24 mEq/L.