Clinical review: the meaning of acid-base abnormalities in the intensive care unit. Acetazolamide-mediated decrease in strong ion. [33] Atkins CE, Tyler R, Greenlee P. Clinical, biochemical, acid-base, and electrolyte abnormalities. acetazolamide cystoid macular edemanew/7061-1-19600.phpnew/1894-1-20422.phpnew/5690-1-20664.php are a number of causes for this abnormality including distal renal tubular acidosis, hypokalemia, diets rich in animal protein and or diets low in alkali and certain drugs, such as acetazolamide. Miner Electrolyte Metab 1987; 13: 257-66. The maximum urinary pCO2 test using acetazolamide and sodium bicarbonate is an. 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