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 CO3
2

 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- ]/[H2CO3] = K
3

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 (Co2 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 HCO3

Variable reabsorption of filtered HCO3
back into the plasma in conjunction
with H secretion.
Variable addition of new HCO3 to the
plasma in conjunction with H
secretion.
Variable secretion of HCO3 in
conjunction with H+ reabsorption.

Additional buffer systems in

the kidney
Filtered Phosphate
Secreted NH3

TERIMA KASIH