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Acid-Base Equilibrium
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Acid-Base Equilibrium
For living organisms to maintain homeostasis, the body undergoes many adaptations.
Establishing and maintaining an acid-base equilibrium is one of the adaptations. Under normal
circumstances, the power of hydrogen (PH) of the human body ranges between 7.35 and 7.45.
This range is ideal for most biological processes, importantly oxygenation. Also, at a neutral PH,
most components in biochemical reactions become ionized, making it difficult for them to be
utilized in the body (Appel and Downs 2008). Therefore, the body's PH should be slightly
alkaline. Any alteration of the body's PH results in abnormalities and disorders in the body
functions. The following write-up seeks to impart a better understanding of the concept of acid-
base equilibrium and the abnormalities that come with the PH alteration.
According to Appel and Downs (2008), the body's metabolic processes produce acid and
a lower base quantity. The metabolism of carbohydrates and fats produces the most acid in the
body. These metabolisms produce carbon dioxide in large quantities, combined with water in the
blood to form carbonic acid, which is utilized in the oxygenation process. Additional lesser
amounts of acid come from hydrolysis of dietary phosphate, incomplete metabolism of glucose
and fatty acids, and metabolism of cationic amino acids. These acids ought to be neutralized by
the base in the body or excreted by the kidneys. On the other hand, most bases are produced from
For the body to maintain ideal cellular function, the body has several elaborate
mechanisms that enable the body to maintain the perfect acid-base equilibrium.
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Chemical buffering is one way through which the body maintains acid-base balance. This
mechanism is comprised of chemical buffers that resist changes in PH in the body. These buffers
include weak acid and conjugate bases that are released in response to acid-base equilibrium
hemoglobin in the red blood cells, and bones are also essential chemical buffers. Bones act as
buffers since they contain large amounts of reserves for bicarbonates and phosphates, which
significantly buffers critical drastic acid load. In the case of a long-lasting acidemia, the bones
The tidal volume of carbon dioxide in the blood determines the level of acidity. Chemoreceptors
in the arteries detect a decrease in PH, leading to an increased rate of respiration to eliminate
carbon dioxide that combines with water in the blood to lower the PH. When carbon dioxide is
exhaled, the blood PH is increased. The pulmonary regulation is a little slower than chemical
On another note, the body's PH is controlled through renal PH regulation by the kidneys.
Kidneys adjust the quantities of bicarbonate through excretion or reabsorption. In alkalosis, the
bicarbonates are excreted, and hydrogen ions retained in the form of organic acids, while in
acidosis, hydrogen ions are eliminated, and bicarbonates are retained to regulate the acid-base
balance. The kidneys also actively excrete acids together with the urinary buffers transported
outside the body. The pulmonary PH regulation reduces the workload of the kidney to regulate
the acid-base equilibrium in the blood. This process takes several hours or days after the
An acid-base equilibrium below 7.35 indicates that the body has a condition referred to as
acidemia. While acid-base equilibrium above 7.45 results in alkalemia (Appel and Downs,
2008). Most of the disorders are mild and don't require treatment. Sometimes treatments can
result in more harm than the disorder itself. Therefore, acid-base imbalance treatment should be
done accurately and avoided where possible. According to Lewis J. (2020), the human body
experiences four common acid-base equilibrium disorders; metabolic acidosis and alkalosis, and
Metabolic Acidosis
Metabolic acidosis is a condition that arises from an increase in the total body acidity
caused by excessive production of acid in the body or extreme loss of bicarbonates, sodium, and
potassium. In most cases, bicarbonates are lost through severe diarrhea and wasting through the
kidneys and gastrointestinal tract. Additionally, the condition may be caused by lactic acidosis
and diabetic ketoacidosis. In severe acidosis, the potassium in the body may deplete since the
potassium moves from the cells to the extracellular fluid to maintain electroneutrality (Lewis, J.
2020). This condition explains why patients with diabetic ketoacidosis are given potassium-rich
Metabolic Alkalosis
Metabolic alkalosis is a condition that occurs when bicarbonate ions increase due to
excessive loss of metabolic acids in the body tissues (Lewis, J. 2020). Mainly, this condition is
caused by diuretics, emesis, secretory adenoma of the colon, and exogenous steroids, among
others.
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Most of the cases respond to treatment a small percentage of about 0.9% sodium chloride
solution. Metabolic alkalosis occurs in two different kinds; chloride- responsive alkalosis and
chloride- resistant alkalosis. Chloride-responsive alkalosis occurs due to the loss of hydrogen
ions, commonly through vomiting and dehydration. On the other hand, chloride-resistant
alkalosis results when too many bicarbonate ions are retained in the body tissues or when
hydrogen ions move from the blood to the body tissues (Gillion et al., 2018).
Respiratory Acidosis
According to Adrogué & Madias (2017), respiratory acidosis is a condition that occurs
when the lungs are unable to remove carbon dioxide from the body effectively. The excessive
carbon dioxide in the body causes an increased acidity of the blood and other body fluids.
Respiratory acidosis occurs in two forms; acute respiratory acidosis, which can be life-
threatening when left untreated and happens quickly. Chronic respiratory acidosis that develops
with time having no symptoms. The body adapts to chronic respiratory acidosis, but it can
advance to acute respiratory acidosis when one develops another disease. These conditions are
treated by cleansing the airways and treating an infection that may result in acute respiratory
Respiratory Alkalosis
Respiratory alkalosis is a variation of the acid-base balance in the body due to decreased
partial pressure of the arterial carbon dioxide. This condition is caused by increased alveolar
ventilation due to hyperventilation, hepatic disease, septicemia, and mechanical over ventilation.
In critical conditions, the partial pressure of carbon dioxide is below the normal range, and the
PH is alkalemia. In contrast, in chronic illness, the serum PH remains relatively normal due to
level of bicarbonate ions which may cause a mixed acid-base disorder. Mixed acid-base balance
2017).
In conclusion, the human body requires a maintained acid-base balance for normal body
functions. The ideal acid-base balances range between 7.35 and 7.45, of which any PH value
short of or more than the range results in acidosis and alkalosis, respectively. The condition is
classified into those related to metabolism and respiratory-related acidosis or alkalosis. The body
has different compensatory mechanisms for the disorders, but there is a need for medical
References
Appel, S. and Downs, C., 2008. Understanding acid-base balance. Nursing, 38, pp.9-11.
Lewis, J., 2020. Acid-Base Regulation - Endocrine and Metabolic Disorders - MSD Manual
<https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/acid-
base-regulation-and-disorders/acid-base-regulation?query=Overview%20of%20Acid-
Adrogué, H. and Madias, N., 2017. Respiratory Acidosis and Alkalosis. DeckerMed Medicine,
Gillion, V., Jadoul, M., Devuyst, O. and Pochet, J., 2018. The patient with metabolic