It is usually done when the kidneys fail or after a severe drug overdose. All medications have possible side effects. For example, antibiotics may caus allergic reactions and stomach upset. Other side effects may occur and depend on the medications used. Dialysis carries a risk for low blood pressure, infection and other problems.
Surgery carries a risk of bleeding and infection.
If the underlying cause of the metabolic acidosis can be treated, the acid levels in the body usually return to normal. In these cases, no further treatment may be needed. Those with permanent kidney failure may need dialysis for the rest of their lives. Repeated blood tests can be done to follow the acid level in the blood if needed. Other monitoring relates to the cause.