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The kidneys maintain acid-base balance through the excretion of an amount
of acid equal to the amount of non-volatile acid produced via metbolism and the
quantity ingested in the diet.
HCO3 filtered at the glomeruli is maintained by reabsorption mechanisms.
HCO3 filtration and secretion as well as excretion of acid are accomplished
via H secretion by nephrons. Acid is excreted in the form of titratable acid (Pi) and
The excretion of Pi and NH4 results to generation of new HCO3 which
replenishes the ECF HCO3 lost during the neutralization of non-volatile acids.
The Body uses 3 lines of defense to minimise the impact of acid base
disorders on body fluid PH
ECF and ICF buffering
Respiratory Compensation
Renal Compensation
METABOLIC acid-base disorders are caused by primary alterations in ECF
which is a results from the addition of acid to or loss of alkali from the body.
During PULMONARY ACIDOSIS- pulmonary ventilation is increased which
decreases PCO2 and renal net acid excretion is increased.
An increase in ECF HCO3 levels causes ALKALOSIS which decreases
pulmonary ventilation which in turn elevates PCO2
Pulmonary response to acid-base imbalances occurs in short periods of time
while metabolic responses may take several dase
Respiratory acid-base disorders result from primary alterations in PCO2.
Elevation of PCO2 produces acidosis and thus, the kidneys respond with an
increase in net acid excretion.
A reduction in PCO2 produceses alkalosis and renal net acid excretion is