Regulation of Acid Base Balance

by the Kidneys
IRBAB HAWARI
Acid Base Balance
Regulation of Free [H]
+
in the body fluids
Acids are a special group of hydrogen-
containing substances that dissociate, or
separate, when in solution to liberate free H
and anions (negatively charged ions)
Strong acid---HCl
Weak Acid---H
2
CO3
A base is a substance that can combine with a
free H and thus remove it from solution. A
strong base can bind H more readily than a
weak base can.
dissociation constant (K)
Example :
[H][HCO
-
3
]/[H2CO3] = K
pH
pH = log 1/[H
+
]
Neutral pH =7.0
< neutral = acidic
> neutral = alkaline
ACIDOSIS AND ALKALOSIS IN THE
BODY
pH of arterial blood = 7.45
pH of venous blood = 7.35
Average = 7.4
< 7.35 = acidosis
> 7.45 = alkalosis
Why it is important to regulate [H+]?
Changes in excitability of nerve and muscle
cells
Influence on enzyme activity
Influence K
+
levels
Sources of H+ in the body
Carbonic acid formation (Co
2
metabolism)





Inorganic acids produced during breakdown of nutrients.
Sulfuric acid and phosphoric acid
Organic acids resulting from intermediary metabolism
Lactic acid
Fatty acid

THREE LINES OF DEFENSE AGAINST
CHANGES IN [H
+
]
The chemical buffer systems
the respiratory mechanism of pH control
the renal mechanism of pH control
Handerson-Hasselbach Equation
Kidney Regulation of Acid Base
Balance
H
+
is mostly secreted
Urine pH is is about 6.0
H+ secretion in proximal tubule
H
+
ATP ase pumps
Na
+
-H
+
antiporters
H
+
secretion in the distal and collecting
tubules
Type A intercalated cells


Type B intercalated cells

The regulation of HCO
3
Variable reabsorption of filtered HCO
3
back
into the plasma in conjunction with H
secretion.
Variable addition of new HCO
3
to the plasma
in conjunction with H secretion.
Variable secretion of HCO
3
in conjunction with
H
+
reabsorption.



Additional buffer systems in the kidney
Filtered Phosphate

Secreted NH
3



TERIMA KASIH