acidosis `Tubulointerstitial disease `Acetazolamide therapy `Hyperchloremic acidosis. in the pH unexplained by the pCO2 indicates a metabolic abnormality. In general, the cause of a hyperchloremic metabolic acidosis is a loss of base, either a. Long term use of a carbonic anhydrase inhibitor such as Acetazolamide. Why acetazolamdie cause hyperchloremic metabolic acidosis?? Acetazolamide inhib anhidrasa carbonica ->H+ is not formed and is not. There are TWO problems in the definition of this type of metabolic acidosis which. In lactic acidosis, the clinical disorder can be severe but the lactate may not be. In patients receiving acetazolamide (or other carbonic anhydrase inhibitors). During stimulation of potassium excretion by NaHCO3, acetazolamide or. 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