Acid-Base Balance

Gian Carlo Delante, PhB PTRP RPT

 Acids & Bases
• Acid
– Any molecule that will release hydrogen ions (H+)
when put in a solution
– Hydrochloric acid: HCl
• Base
– Any molecule that will accept a hydrogen ion (H+)
when put in a solution
– Bicarbonate ions: HCO3
pH Scale
 pH Scale
• Neutral (as
opposed to
normal) pH is 7
• Arterial blood pH
is 7.45
• Venous blood pH
is 7.35
• Acidosis: body
fluid pH is below
7.4
• Alkalosis: body
fluid pH is above
7.4
 Sources of Acid in the Body
• Respiratory system
– CO2 (byproduct of ATP production)
– Binds with H2O to form carbonic acid (volatile
acid)

• Metabolic breakdown of proteins

– Sulphuric acid, phosphoric acid, lactic acid, and
organic acids (non-volatile acids)
 Regulation of Hydrogen Ion
Concentration
• Because various types of acids are being produced
by the body constantly, the body must have a way
to deal with potential increases in free hydrogen
(acidosis)
• Mechanisms that regulate H concentration:
– Buffers
– Respiratory system
• Regulate H concentration from volatile acids
• Responds quickly within seconds to minutes
– Kidneys
• Regulate H concentration from non-volatile acids
• Responds more slowly, over a period of hours to days
 Buffers
• Any molecule that can reversibly bind (or
release) free hydrogen ion
• Help to minimize any pH change until the free
H can be removed from the body by either the
lungs or kidneys or both
• Examples:
– Bicarbonate ions (extracellular buffer)
– Hemoglobin (intracellular buffer)
Regulation of H+ Concentration:
Respiratory System
 Regulation of H+ Concentration:
The Kidneys
• Kidneys take care of the non-volatile acids that
are constantly produced in the body
• Kidneys maintain normal pH when they:
– Excrete H ions that come from non-volatile acids
– Reabsorb bicarbonate ions filtered at the
glomerulus
– Create new bicarbonate ions
Abnormal pH: Alkalosis & Acidosis
• Acidosis
– Too much acid (H) or too little bicarbonate ion
(HCO3)
– Types: Respiratory acidosis & Metabolic acidosis
• Alkalosis
– Too much bicarbonate (HCO3) or too little acid (H)
– Types: Respiratory alkalosis & Metabolic alkalosis
 Respiratory Acidosis & Alkalosis
• Respiratory acidosis
– Caused by decreased ventilation & increased
PCO2: from damaged respiratory centers in the
brain stem or from lung damage

• Respiratory alkalosis
– Caused by increased ventilation & decreased
PCO2: from emotionally induced hyperventilation
or high altitudes
 Metabolic Acidosis & Alkalosis
• Metabolic acidosis
– Decreased extracellular bicarbonate ions
– Causes:
• Kidney failure
• Formation of excess metabolic acids
• Ingestion of acids (aspirin & methyl alcohol)
• Loss of bicarbonate ions in diarrhea
• Metabolic Alkalosis
– Caused by either build-up of bicarbonate ions or
loss of H from the body
• Loss of HCl from stomach due to vomiting
• Ingestion of alkaline drugs (Na bicarbonate for ulcers)