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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. An 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 comes with the PH alteration.

Sources of Body Acid and Base

According to Appel and Downs (2008), the body's metabolic processes produce acid and

base at a lower quantity than acid. 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 the metabolism of anionic amino acids and organic anions.

Body Mechanisms to Maintain Acid-Base Equilibrium

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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. 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 comprise

weak acid and conjugate bases that are released in response to acid-base equilibrium

disturbances. Additionally, intracellular organic and inorganic phosphates and proteins,

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

become demineralized leading to osteoporosis (Appel and Downs, 2008).

Secondly, the body maintains acid-base equilibrium through pulmonary PH regulation.

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

buffering and doesn't wholly normalize the body's PH (Lewis, J. 2020).

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 excreted, 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
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the acid-base equilibrium in the blood. This process takes several hours or days after the

undesirable change in the acid-base equilibrium (Lewis, J. 2020).

Acid-Base Disorders and Abnormalities

If the acid-base equilibrium falls below 7.35, the body has a condition referred to as

acidemia, while 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 respiratory acidosis and

alkalosis.

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

medication early in treatment.

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Metabolic Alkalosis

Metabolic alkalosis is a condition that occurs when bicarbonate ions increase commonly

due to excessive loss of metabolic acids in the body tissues. Mainly, this condition is caused by

diuretics, emesis, secretory adenoma of the colon, and exogenous steroids, among others. 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, while chloride resistant alkalosis result 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.

Commonly, this condition is caused by underlying conditions referred to as ventilatory failure.

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 through the cleansing of the airways and treatment of an infection that may result in acute

respiratory acidosis from chronic acidosis.

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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.

Respiratory alkalosis happens in chronic and acute conditions. 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 compensatory mechanisms.

Notably, the compensatory mechanisms cause a reduction in the level of bicarbonate ions which

may cause a mixed acid-base disorder. Mixed acid-base balance disorder occurs as a result of

inappropriate compensatory mechanisms (Adrogué & Madias 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

intervention, especially when the conditions are acute.

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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

Professional Edition. [online] MSD Manual Professional Edition. Available at:

<https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/acid-

base-regulation-and-disorders/acid-base-regulation?query=Overview%20of%20Acid-

Base%20Balance> [Accessed 5 May 2021].

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

alkalosis. Acta Clinica Belgica, 74(1), pp.34-40.