Organic acids, such as lactic acid, acetic acid, and citric acid, are used in clinical settings to treat alkalosis, particularly metabolic or respiratory alkalosis, based on well-established physiological principles. Alkalosis refers to an elevated blood pH (above 7.45), which can disrupt cellular function and metabolic processes. The therapeutic rationale for using organic acids is that they can donate hydrogen ions (H⁺), thereby lowering blood pH toward normal levels.

In cases of severe alkalosis—especially when associated with volume depletion or persistent vomiting—patients may receive intravenous infusions containing organic acid salts (e.g., potassium chloride with acetate or lactate), which the body metabolizes to release H⁺ ions. This approach is supported by medical textbooks and clinical guidelines (e.g., Batlle & Arruda, N Engl J Med 2000; Galla, Kidney Int 2000), which describe the use of organic acids in correcting alkalotic states when direct acid administration (like hydrochloric acid) poses greater risks or is impractical.

While sodium or potassium chloride is often the first-line therapy for chloride-responsive alkalosis, organic acids are scientifically validated as safe and effective alternatives in specific contexts, such as in patients who cannot tolerate chloride loads. Systematic reviews and clinical case series report successful correction of alkalosis using these acids, justifying a relatively high evidence score.