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Describe How The Kidneys Respond To Respiratory Acidosis

Renal Regulation Of Metabolic Acidosis And Alkalosis

Renal Regulation Of Metabolic Acidosis And Alkalosis

1. 06/21/14 1 Normal Acid-Base Balance • Normal pH 7.35-7.45 • Narrow normal range • Compatible with life 6.8 - 8.0 ___/______/___/______/___ 6.8 7.35 7.45 8.0 Acid Alkaline 2. 06/21/14 2 PH Scale 3. 06/21/14 3 Acid & Base • Acid: • An acid is "when hydrogen ions accumulate in a solution" • It becomes more acidic • [H+] increases = more acidity • CO2 is an example of an acid. Base: A base is chemical that will remove hydrogen ions from the solution Bicarbonate is an example of a base. 4. 06/21/14 4 Acid and Base Containing Food: • To maintain health, the diet should consist of 60% alkaline forming foods and 40% acid forming foods. To restore health, the diet should consist of 80% alkaline forming foods and 20% acid forming foods. • Generally, alkaline forming foods include: most fruits, green vegetables, peas, beans, lentils, spices, herbs,seasonings,seeds and nuts. • Generally, acid forming foods include: meat, fish, poultry, eggs, grains, and legumes. 5. 06/21/14 5 Citric Acid And Lactic Acid Although both citric acid and lactic acid are acids BUT Citric acid leads to Alkalosis while Lactic acid to Acidosis due to metabolism 6. 06/21/14 6 Acidoses & Alkalosis • An abnormality in one or more of the pH control mechanisms can cause one of two major disturbances in Acid-BaseAcid-Base balance – AcidosisAcidosis – AlkalosisAlkalosis 7. 06/21/14 7 Acidosis • Acidosis is excessive blood acidity caused by an overabundance of acid in the blood or a loss of bicarbonate from the blood (metabolic acidosis), or by a buildup of carbon dioxide in the blood that results from poor lung function or slow breathing (respiratory acidosis). • Blood acidity increases when people ingest substances that contain or produce acid or when the lungs do not expel enou Continue reading >>

4.5 Respiratory Acidosis - Compensation

4.5 Respiratory Acidosis - Compensation

Acid-Base Physiology 4.5.1 The compensatory response is a rise in the bicarbonate level This rise has an immediate component (due to a resetting of the physicochemical equilibrium point) which raises the bicarbonate slightly. Next is a slower component where a further rise in plasma bicarbonate due to enhanced renal retention of bicarbonate. The additional effect on plasma bicarbonate of the renal retention is what converts an "acute" respiratory acidsosis into a "chronic" respiratory acidosis. As can be seen by inspection of the Henderson-Hasselbalch equation (below), an increased [HCO3-] will counteract the effect (on the pH) of an increased pCO2 because it returns the value of the [HCO3]/0.03 pCO2 ratio towards normal. pH = pKa + log([HCO3]/0.03 pCO2) 4.5.2 Buffering in Acute Respiratory Acidosis The compensatory response to an acute respiratory acidosis is limited to buffering. By the law of mass action, the increased arterial pCO2 causes a shift to the right in the following reaction: CO2 + H2O <-> H2CO3 <-> H+ + HCO3- In the blood, this reaction occurs rapidly inside red blood cells because of the presence of carbonic anhydrase. The hydrogen ion produced is buffered by intracellular proteins and by phosphates. Consequently, in the red cell, the buffering is mostly by haemoglobin. This buffering by removal of hydrogen ion, pulls the reaction to the right resulting in an increased bicarbonate production. The bicarbonate exchanges for chloride ion across the erythrocyte membrane and the plasma bicarbonate level rises. In an acute acidosis, there is insufficient time for the kidneys to respond to the increased arterial pCO2 so this is the only cause of the increased plasma bicarbonate in this early phase. The increase in bicarbonate only partially returns the extracel Continue reading >>

Egan's Ch. 13

Egan's Ch. 13

what is the state called in which arterial blood is more acidic than normal? aka increased concentration of hydrogen ions. Flashcards Matching Hangman Crossword Type In Quiz Test StudyStack Study Table Bug Match Hungry Bug Unscramble Chopped Targets Acid-Base Balance Question Answer what is the state called in which arterial blood is more acidic than normal? aka increased concentration of hydrogen ions. acidemia what is the difference called between the normal buffer base and the actual buffer base in a whole blood sample? base excess (BE) what is alkalemia? decreased hydrogen ion concentration in the blood; blood pH greater than 7.45 how is BE expressed? mEq/L what is the normal BE? +2 mEq/L what is the buffer base? the total blood buffer capable of binding hydrogen ions what is the normal blood buffer base (NBB) range? 48-52 mEq/L what is a titrable, nonvolitile acid called? fixed acid what does a fixed acid represent? the by-product of protein catabolism what kind of acids are phosphoric acid and sulfuric acid? fixed what is the Henderson-Hasselbalch (H-H) equation? the specific equation for calculating the pH of the bicarbonate buffer system of the blood what does pH = 6.1 + log HCO3-/(PaCO2 x 0.03) represent? H-H equation what is the importance of the H-H equation? it equals the pH of blood plasma, and since all buffer systems in the blood are in equilibrium, the pH of one system equals the pH of the entire plasma solution. what is hypercapnia? excess amounts of CO2 in the blood (PaCO2) what is the presence of lower than normal amounts of CO2 in the blood (PaCO2)? hypocapnia define metabolic acidosis? non-respiratory processes resulting in acidemia what is called when non-respiratory processes, such as losing fixed acid or gaining HCO3-, result in alkalemia? metabo Continue reading >>

Shared Flashcard Set

Shared Flashcard Set

Details Title Acid Base Balance Description Acid Base Balance Total Cards 214 Subject Nursing Level Undergraduate 2 Created 10/14/2012 Click here to study/print these flashcards. Create your own flash cards! Sign up here. Additional Nursing Flashcards Cards Term An opioid drug overdose would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Pulmonary Edema would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Chest trauma would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Neuromuscular disease would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term COPD would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Airway obstruction would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Pneumonia would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term TB would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Emphysema would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Asthma would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Cigarrette smoking would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term Pleural effusion would put a patient at most risk for what acid/base imbalance? Definition Respiratory Acidosis Term What is pleural effusion? Definition excess fluid that accumulates in the pleura, the fluid-filled space that surrounds the lungs Pleural effusion is excess fluid that accu Continue reading >>

Response To Disturbances

Response To Disturbances

The body tries to minimize pH changes and responds to acid-base disturbances with body buffers, compensatory responses by the lungs and kidney (to metabolic and respiratory disturbances, respectively) and by the kidney correcting metabolic disturbances. Body buffers: There are intracellular and extracellular buffers for primary respiratory and metabolic acid-base disturbances. Intracellular buffers include hemoglobin in erythrocytes and phosphates in all cells. Extracellular buffers are carbonate (HCO3–) and non-carbonate (e.g. protein, bone) buffers. These immediately buffer the rise or fall in H+. Compensation: This involves responses by the respiratory tract and kidney to primary metabolic and respiratory acid-base disturbances, respectively. Compensation opposes the primary disturbance, although the laboratory changes in the compensatory response parallel those in the primary response. This concept is illustrated in the summary below. Respiratory compensation for a primary metabolic disturbance: Alterations in alveolar ventilation occurs in response to primary metabolic acid-base disturbances. This begins within minutes to hours of an acute primary metabolic disturbance. Note that complete compensation via this mechanism may take up to 24 hours. Renal compensation for a primary respiratory disturbance: Here, the kidney alters excretion of acid (which influences bases as well) in response to primary respiratory disturbances. This begins within hours of an acute respiratory disturbance, but take several days (3-5 days) to take full effect. Correction of acid-base changes: Correction of a primary respiratory acid-base abnormality usually requires medical or surgical intervention of the primary problem causing the acid-base disturbance, e.g. surgical relief of a colla Continue reading >>

Acid-base Balance

Acid-base Balance

Your blood needs the right balance of acidic and basic (alkaline) compounds to function properly. This is called the acid-base balance. Your kidneys and lungs work to maintain the acid-base balance. Even slight variations from the normal range can have significant effects on your vital organs. Acid and alkaline levels are measured on a pH scale. An increase in acidity causes pH levels to fall. An increase in alkaline causes pH levels to rise. When the levels of acid in your blood are too high, it’s called acidosis. When your blood is too alkaline, it is called alkalosis. Respiratory acidosis and alkalosis are due to a problem with the lungs. Metabolic acidosis and alkalosis are due to a problem with the kidneys. Each of these conditions is caused by an underlying disease or disorder. Treatment depends on the cause. When you breathe, your lungs remove excess carbon dioxide from your body. When they cannot do so, your blood and other fluids become too acidic. Symptoms of respiratory acidosis Symptoms may include fatigue, shortness of breath, and confusion. Causes of respiratory acidosis There are several different causes of respiratory acidosis including: chest deformities or injuries chronic lung and airway diseases overuse of sedatives obesity Types of respiratory acidosis There are no noticeable symptoms of chronic respiratory acidosis. This is due to the fact that your blood slowly becomes acidic and your kidneys adjust to compensate, returning your blood to a normal pH balance. Acute respiratory acidosis comes on suddenly, leaving the kidneys no time to adjust. Those with chronic respiratory acidosis may experience acute respiratory acidosis due to another illness that causes the condition to worsen. Diagnosis of respiratory acidosis A complete physical examination Continue reading >>

Acid-base Balance

Acid-base Balance

pH, Buffers, Acids, and Bases Acids dissociate into H+ and lower pH, while bases dissociate into OH− and raise pH; buffers can absorb these excess ions to maintain pH. Learning Objectives Explain the composition of buffer solutions and how they maintain a steady pH Key Takeaways A basic solution will have a pH above 7.0, while an acidic solution will have a pH below 7.0. Buffers are solutions that contain a weak acid and its a conjugate base; as such, they can absorb excess H+ ions or OH– ions, thereby maintaining an overall steady pH in the solution. pH is equal to the negative logarithm of the concentration of H+ ions in solution: pH = −log[H+]. Key Terms alkaline: having a pH greater than 7; basic acidic: having a pH less than 7 buffer: a solution composed of a weak acid and its conjugate base that can be used to stabilize the pH of a solution Self-Ionization of Water Hydrogen ions are spontaneously generated in pure water by the dissociation (ionization) of a small percentage of water molecules into equal numbers of hydrogen (H+) ions and hydroxide (OH−) ions. The hydroxide ions remain in solution because of their hydrogen bonds with other water molecules; the hydrogen ions, consisting of naked protons, are immediately attracted to un-ionized water molecules and form hydronium ions (H30+). By convention, scientists refer to hydrogen ions and their concentration as if they were free in this state in liquid water. The concentration of hydrogen ions dissociating from pure water is 1 × 10−7 moles H+ ions per liter of water. The pH is calculated as the negative of the base 10 logarithm of this concentration: pH = −log[H+] The negative log of 1 × 10−7 is equal to 7.0, which is also known as neutral pH. Human cells and blood each maintain near-neutral pH. p Continue reading >>

Fluid/electrolyte Balance

Fluid/electrolyte Balance

Content Body Fluids Compartments Composition of Body Fluids Electrolyte Composition of Body Fluids Extracellular and Intracellular Fluids Fluid Movement Among Compartments Fluid Shifts Regulation of Fluids And Electrolytes Water Balance and ECF Osmolality Water Output Regulation of Water Intake Regulation of Water Output Primary Regulatory Hormones Disorders of Water Balance Electrolyte Balance Sodium in Fluid and Electrolyte Balance Sodium balance Regulation of Sodium Balance: Aldosterone Atrial Natriuretic Hormone (ANH) Potassium Balance Regulation of Potassium Balance Regulation of Calcium Regulation of Anions Acid-Base Balance Sources of Hydrogen Ions Hydrogen Ion Regulation Chemical Buffer Systems -- 1. Bicarbonate Buffer System - -2. Phosphate Buffer System -- 3. Protein Buffer System Physiological Buffer Systems Renal Mechanisms of Acid-Base Balance Reabsorption of Bicarbonate Generating New Bicarbonate Ions Hydrogen Ion Excretion Ammonium Ion Excretion Bicarbonate Ion Secretion Respiratory Acidosis and Alkalosis Respiratory Acid-Base Regulation Metabolic pH Imbalance Respiratory/Renal Compensation/Metabolic Acidosis Metabolic Alkalosis Fluid Balance- The amount of water gained each day equals the amount lost Electrolyte Balance - The ions gained each day equals the ions lost Acid-Base Balance - Hydrogen ion (H+) gain is offset by their loss Body Fluids Compartments Intracellular Fluid (ICF) - fluid found in the cells (cytoplasm, nucleoplasm) comprises 60% of all body fluids. Extracellular Fluid (ECF) - all fluids found outside the cells, comprises 40% of all body fluids Interstitial Fluid - 80% of ECF is found in localized areas: lymph, cerebrospinal fluid, synovial fluid, aqueous humor and vitreous body of eyes, between serous and visceral membranes, glomerular Continue reading >>

Respiratory Acidosis

Respiratory Acidosis

Practice Essentials Respiratory acidosis is an acid-base balance disturbance due to alveolar hypoventilation. Production of carbon dioxide occurs rapidly and failure of ventilation promptly increases the partial pressure of arterial carbon dioxide (PaCO2). [1] The normal reference range for PaCO2 is 35-45 mm Hg. Alveolar hypoventilation leads to an increased PaCO2 (ie, hypercapnia). The increase in PaCO2, in turn, decreases the bicarbonate (HCO3–)/PaCO2 ratio, thereby decreasing the pH. Hypercapnia and respiratory acidosis ensue when impairment in ventilation occurs and the removal of carbon dioxide by the respiratory system is less than the production of carbon dioxide in the tissues. Lung diseases that cause abnormalities in alveolar gas exchange do not typically result in alveolar hypoventilation. Often these diseases stimulate ventilation and hypocapnia due to reflex receptors and hypoxia. Hypercapnia typically occurs late in the disease process with severe pulmonary disease or when respiratory muscles fatigue. (See also Pediatric Respiratory Acidosis, Metabolic Acidosis, and Pediatric Metabolic Acidosis.) Acute vs chronic respiratory acidosis Respiratory acidosis can be acute or chronic. In acute respiratory acidosis, the PaCO2 is elevated above the upper limit of the reference range (ie, >45 mm Hg) with an accompanying acidemia (ie, pH < 7.35). In chronic respiratory acidosis, the PaCO2 is elevated above the upper limit of the reference range, with a normal or near-normal pH secondary to renal compensation and an elevated serum bicarbonate levels (ie, >30 mEq/L). Acute respiratory acidosis is present when an abrupt failure of ventilation occurs. This failure in ventilation may result from depression of the central respiratory center by one or another of the foll Continue reading >>

Disorders Of Acid-base Balance

Disorders Of Acid-base Balance

Learning Objectives By the end of this section, you will be able to: Identify the three blood variables considered when making a diagnosis of acidosis or alkalosis Identify the source of compensation for blood pH problems of a respiratory origin Identify the source of compensation for blood pH problems of a metabolic/renal origin Normal arterial blood pH is restricted to a very narrow range of 7.35 to 7.45. A person who has a blood pH below 7.35 is considered to be in acidosis (actually, “physiological acidosis,” because blood is not truly acidic until its pH drops below 7), and a continuous blood pH below 7.0 can be fatal. Acidosis has several symptoms, including headache and confusion, and the individual can become lethargic and easily fatigued. A person who has a blood pH above 7.45 is considered to be in alkalosis, and a pH above 7.8 is fatal. Some symptoms of alkalosis include cognitive impairment (which can progress to unconsciousness), tingling or numbness in the extremities, muscle twitching and spasm, and nausea and vomiting. Both acidosis and alkalosis can be caused by either metabolic or respiratory disorders. As discussed earlier in this chapter, the concentration of carbonic acid in the blood is dependent on the level of CO2 in the body and the amount of CO2 gas exhaled through the lungs. Thus, the respiratory contribution to acid-base balance is usually discussed in terms of CO2 (rather than of carbonic acid). Remember that a molecule of carbonic acid is lost for every molecule of CO2 exhaled, and a molecule of carbonic acid is formed for every molecule of CO2 retained. Metabolic Acidosis: Primary Bicarbonate Deficiency Metabolic acidosis occurs when the blood is too acidic (pH below 7.35) due to too little bicarbonate, a condition called primary bicar Continue reading >>

Regulation Of Acid-base Balance

Regulation Of Acid-base Balance

There is precise regulation or maintenance of ‘free H+ ions’ in body fluids. Balance is Achieved by Three Defense Mechanisms:- • First defense: Chemical buffering • 2nd defense: Respiratory (alteration in arterial CO2) • 3rd defense: Renal (alteration in HCO-3 excretion) Acid Base Regulation/Balance 1. Chemical Buffer system: – Responds within seconds – Does not eliminate or add H+ from body – Operates by binding or to tied up H+ till balance is reestablished. a. In ECF: – Mainly HCO-3/CO2 Buffer system – Plasma Proteins – HPO–4/H2PO-4 Buffer system b. In ICF: – Proteins Mainly e.g.: Hb in RBCs – HPO–4/H2PO-4 Buffer system Routes of excretion of acids; lungs & kidneys 2. Respiratory Mechanisms: – Responds within minutes – Takes 6-12 hours to be fully effective – Operates by excreting CO2 or (adding H2CO3/HCO-3) 3. Renal Mechanisms: • Responds slowly (effectively in 3-5 days) • Eliminates excess Acids or Base from body • The most powerful mechanism e.g. i. HCO-3/CO2 Buffer system ii. NH3/NH+4 Buffer system iii. HPO–4/H2PO-4 Buffer system Chemical Buffer System • Consists of a ‘pair of substances’ present in a mixture of a solution that ‘minimizes pH changes’ when an ‘acid or base’ is ‘added or removed’ from the solution. • Consists of; 1. Carbonic Acid – Bicarbonate Buffer System 2. Phosphate Buffer system 3. Protein Buffer system Chemical Buffer System of ECF 1. Bicarbonate Buffer System: H2CO3/NaHCO3 consists of H2CO3 (weak Acid) + NaHCO3 (Bicarbonate salt) – CO2 + H2O ↔H2CO3 ↔ H+ + HCO-3 – NaHCO3 ↔ Na+ + HCO-3 → H2CO3 → CO2 + H2O Bicarbonate buffer system is quantitatively the most powerful ECF buffer system Its two components HCO-3 & CO2 are precisely regulated by kidneys & lungs. 2. Phos Continue reading >>

Renal Physiology Acid-base Balance

Renal Physiology Acid-base Balance

Sort Your patient's blood pH is too low (acidosis), caused by metabolic acidosis. After examining the patient, you find that the urine bicarbonate levels are too low (H+ is being reabsorbed) and blood carbon dioxide levels are too high (too much blood acid); What does this mean? Based on the patient's pCO2 levels are they compensating or not? This means that the original problem of a low bicarbonate level needs to be compensated for by the lungs, which need to hyperventilate, expelling more CO2 (an acid). Since this patient's pCO2 levels are also high (not expelling enough acid), they are NOT compensating. Patient's blood pH is too high (alkalosis). This can be caused by either respiratory or metabolic alkalosis. Let's say it is metabolic alkalosis. What do you need to check to see if patient is compensating? If bicarbonate levels are high (too much base) and blood CO2 levels are high (too much acid), what do the lungs need to do to compensate? What does the patient's elevated Pco2 levels tell you? Patients partial pressure of Carbon dioxide and bicarbonate Take shallower breaths to prevent loss of acid Patient is compensating Patient's blood pH is too high (alkalosis). This can be caused by either respiratory or metabolic alkalosis. Let's say it is metabolic alkalosis. What do you need to check to see if patient is compensating? If bicarbonate levels are high (too much base) and blood CO2 levels are low (too little acid), what do the lungs need to do to compensate? Since the patient's pCO2 level is low, this tells you what? Patients pCO2 and bicarbonate Take shallower breaths to prevent loss of acid Not compensating Continue reading >>

Acid–base Homeostasis

Acid–base Homeostasis

Acid–base homeostasis is the homeostatic regulation of the pH of the body's extracellular fluid (ECF).[1] The proper balance between the acids and bases (i.e. the pH) in the ECF is crucial for the normal physiology of the body, and cellular metabolism.[1] The pH of the intracellular fluid and the extracellular fluid need to be maintained at a constant level.[2] Many extracellular proteins such as the plasma proteins and membrane proteins of the body's cells are very sensitive for their three dimensional structures to the extracellular pH.[3][4] Stringent mechanisms therefore exist to maintain the pH within very narrow limits. Outside the acceptable range of pH, proteins are denatured (i.e. their 3-D structure is deranged), causing enzymes and ion channels (among others) to malfunction. In humans and many other animals, acid–base homeostasis is maintained by multiple mechanisms involved in three lines of defence.[5][6] The first line of defence are the various chemical buffers which minimize pH changes that would otherwise occur in their absence. They do not correct pH deviations, but only serve to reduce the extent of the change that would otherwise occur. These buffers include the bicarbonate buffer system, the phosphate buffer system, and the protein buffer system.[citation needed] Physiological corrective measures make up of the second and third lines of defence. This is because they operate by making changes to the buffers, each of which consists of two components: a weak acid and an weak base.[5][7] It is the ratio of weak acid to weak base that determines the pH of the solution.[8] Thus, by manipulating firstly the concentration of the weak acid, and secondly the weak base, the pH of the extracellular fluid (ECF) can be adjusted very accurately to the correct Continue reading >>

Regulation Of Blood Ph

Regulation Of Blood Ph

Although many people are unaware of the fact, maintaining the acid/base balance of your blood is actually vital to your survival. If the pH of your blood drops below 7.2 or rises above 7.6, then very soon your brain will no longer be able to function normally and you will be in dire straits1. As luck would have it, although you cannot consciously detect your blood pH, the human body does in fact have an elegant but effective means of coping with every change in pH, large or small. This relies on three interlinking objects: buffers, the lungs and the kidneys. Buffers pH is a measurement of the concentration of hydrogen H+ ions and buffers are molecules which take in or release ions in order to maintain the H+ ion concentration at a certain level. Buffers in the blood include haemoglobin (Hb), certain proteins (Prot) and phosphates, and are the first line of defence whenever sudden changes in pH occur. When the pH is too low and the blood becomes too acidic, it is due to the presence of too many H+ ions in the blood. The buffers will attempt to mop up the excess. Conversely, a lack of H+ ions leads to the blood becoming too basic, and so the buffers release H+ ions. Buffers therefore help to maintain the pH of the blood by either sacrificing or accepting H+ ions as necessary to maintain the number of free H+ ions floating around in the blood. ← Buffer taking up excess H+ Buffer releasing H+ → H-Hb ↔ Hb- + H+ Prot-H ↔ Prot- + H+ H2PO4- ↔ HPO42- + H+ The Lungs Through these buffer reactions, the pH can be quickly corrected before any damage is done, but this does not provide a long-term solution to the problem. The buffers can only mop up or release so many H+ ions before they reach their capacity and are no longer of any use, and then the situation will once agai Continue reading >>

How The Kidneys Regulate Acid Base Balance

How The Kidneys Regulate Acid Base Balance

Acid-Base Balance Everyday processes like walking, the digestion of food, and the overall metabolism in your body produce a lot of acid as a byproduct. Because of this, you'd be a giant walking lemon if it wasn't for your kidneys. What I mean is, like a lemon, you'd be filled with acid if your kidneys weren't there to help you regulate your body's pH through something we call acid-base balance. This is a process whereby receptors are able to determine the pH of your body and blood and do something about it if it's too acidic or too basic. If an imbalance in the pH is detected by your lungs, buffers, or kidneys, your body springs into action to take care of the problem. In this lesson, we'll focus in on how the kidneys help to control the acid-base balance in your body. Protons and Buffers Whereas the buffers in your body and your lungs are involved in the rapid adjustment of your blood's pH, the kidneys adjust the pH more slowly. Under normal conditions, the kidney's main role in acid-base balance is through the excretion of acid in the form of hydrogen (H+) ions. The kidneys secrete excess hydrogen ions primarily in the proximal tubule. The interesting thing to note is that while the proximal tubule secretes a lot of acid, the tubular fluid's pH remains virtually unchanged. This is because buffers filtered by the glomerulus, including phosphate and bicarbonate, help to minimize the acidity of the tubular fluid. In fact, what's really cool is that the pH of the tubular fluid, by the time it reaches the collecting duct, is about 7.4, which is exactly the pH of normal blood. The Collecting Duct However, by the time urine is excreted out of the body, it can be acidic, basic, or neutral. This is because the end-all, be-all gatekeeper in determining the final pH of urine is Continue reading >>

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