i) Identification and treatment of the underlying cause (if possible)
ii) If there is association with sodium and water depletion – correction accordingly
iii) IV infusion of Bicarbonate (1.26% NaHCO3) can be given if-

a) Underlying cause cannot be corrected readily
b) Severe acidosis (H + concentration is more than 70 nmol/l, pH is less than 7.15)
c) There is evidence of tissue dysfunction.

iv) Haemodialysis- is done as a part of treatment of metabolic acidosis in case of renal failure.