Metabolic acidosis is associated with infection severity in pediatric pyelonephritis and pneumonia

This study demonstrated development of acidosis in 84% of patients with pyelonephritis and in 66% with pneumonia. The mechanism of acidosis appears to have a greater contribution from elevated anion gap in the pneumonia group compared to the pyelonephritis group. Lower nadir serum bicarbonate values are associated with longer hospital length of stay in both groups and greater number of fever days in the pyelonephritis patients.