Regulation of hydrogen Ion

Concentration (Acid-base balance)

Chapter Outcomes:

■ Know the body buffer systems.

■ Describe the gas exchange in the lungs.

■ Describe the respiratory and metabolic components of the

acid–base balance.

■ Define and classify acidosis and alkalosis.

■ Comment on clinical conditions associated with disturbances of

the acid–base balance.
 Regulation of hydrogen Ion
Concentration (Acid-base balance)
Metabolic active cells produce acids (Hydrogen ions) and CO2.
In spite of the amount of hydrogen ion produced, its blood
concentration is remarkably constant. Thus the pH remains
constant as well (7.35–7.45).

Changes in pH and the partial pressure of CO2 affect:

1. Hemoglobin saturation curve and tissue oxygenation
2. Activity of enzymes
3. Cause diseases such as cardiac dysrhythmias
 Which ORGANS/TISSUES maintain the
acid-base balance?
The red blood cells

The Kidney The Lungs

Transportation of gases

Bicarbonate synthesis & re-absorption CO2 / O2 Exchange

H+ excretion
acid-base balance: Overview
Body buffer systems
 Body buffer systems
CELLS PLASMA

[CO2] mmol/L=pCO2 (Kpa) x 0.23

CO2 CO2 + H2O

CA
CO2 + H2O H2CO3
-
HCO3 + H
+

Henderson–Hasselbalch equation:
pH = pKa + log [Bicarbonate] / (pCO2 x 0.23)

pH = 6.1 + log (24 / (5.3 x 0.23))

pH = 7.4
 Buffering H+ and OH- by the
bicarbonate buffer
1- In case of Acidosis
-
HCO3 + H
+ H2CO3 CO2 +H2O

pCO2

2- In case of Alkalosis

H2CO3 + OH
- -
HCO3 + H2O

CO2 + H2O H2CO3

HCO3
-
Intracellular buffering

Acidemia (low plasma pH)/ hyperkalemia

Intracellular buffering

Alkalemia (high blood pH) / hypokalemia.

 Handling of CO2 by Erythrocytes
ERYTHROCYTES / PLASMA
TISSUE LUNG
HCO3- in the plasma
70%

CO2 CO2
20%
Bind Hemoglobin as
Carbamino group

10%
Dissolved in the plasma
Handling of CO2 by Erythrocytes
Handling of CO2 by Erythrocytes

Haldane effect
Dissociation of CO2 from hemoglobin
Facilitated by the high pO2
 Handling of HCO3 - by Kidneys

❑Kidneys control [HCO3-]

➢Reabsorption

➢Synthesis

❑Kidneys remove H+
 -
Handling of HCO3 by Kidneys
Proximal tubules reabsorb bicarbonate
Proximal tubular cell
Glomerular filtrate
Plasma

HCO3-

CO2 + H2O
H+ H2CO3
H2CO3

H2O + CO2
HCO3-
H+
 -
Handling of HCO3 by Kidneys
Distal tubules generate new bicarbonate and excrete hydrogen
Distal tubular cell
Plasma Tubule lumen
Glutamine
NH3
HPO42-
Glutamate
NH3

α- ketoglutarate

HCO3- HCO3- H+ H+

H2CO3
+
NH4 Ammonium ion
CO2 + H2O -
H2PO4
Urine