PCH 201 : Clinical Biochemistry

Basic Biochemistry

Lecture Notes 6 : Metabolic and respiratory acidosis and alkalosis

(Poisons of the repiratory chain)

Mr Willmore Chingwena
Room 146, Dept Biotechnology and Biochemistry
University of Zimbabwe
By the end of these Lecture, you will be able to know the
following :
To describe the role of kidneys in the regulation of acid-base balance
To describe the role of lungs in the regulation of acid-base balance
Symptoms and signs of Acid-Base Imbalances.
Treatments for Acid-Base imbalances
There are 4 Types of Acid- base Imbalances

• Respiratory Alkalosis
• Respiratory Acidosis
• Metabolic Alkalosis
• Metabolic Acidosis
Acidosis Principal effect of acidosis is depression of the CNS through
↓ in synaptic transmission.

Generalized weakness.
• Severe acidosis causes:
• Disorientation
• coma
• death
• Best EX: is Diabetic Ketoacidosis !!

Alkalosis causes over excitability of the central and peripheral

nervous systems. Numbness. Lightheadedness.

It can cause :
• Nervousness
• muscle spasms or tetanic
• Convulsions
• Loss of consciousness
• Death
Respiratory mechanism What are the components of system? The
only component regulated here is CO2 (carbon dioxide) which is volatile
acids- PCO2 (volatile acid

What is the general mechanism? pH can be adjusted by changing

RATE and DEPTH of breathing.

Patient with acidosis → Hyperventilation → wash out CO2 → increase

pH

Patient with alkalosis → Hypoventilation → retain CO2 → Decrease

pH.
Renal mechanism

What is the normal secretion of H+ and reabsorbation of HCO3 per day?

Secretion H+ = 4400 mEq/day Filtration HCO3 = 4320 mEq/day So, the
80 that remains must be titers by ammonia and phosphate buffer systems

Can eliminate large amounts of acid by tubular secretion of H+ . Can

also excrete base by adjusting tubular reabsorption of HCO3 Can
conserve and produce new bicarbonate ions.
Kidney is the most effective regulator of pH. If kidneys fail, pH
balance fails

-In acid-base balance, the kidney is responsible for 2 major activities:

1- Re-absorption of bicarbonate 2- Excretion of Non-volatile acids
Compensation: Restoring pH to normal

Respiratory acidosis (hypoventilation).Renal retention HCO3 – raises

pH toward normal

Respiratory alkalosis.Renal elimination HCO3 – lowers pH toward

normal

Metabolic acidosis.Hyperventilation ↓CO2 , raising pH toward normal

Metabolic alkalosis .Hypoventilation ↑CO2 , lowering pH toward normal

Diagnosis of Acid-Base Imbalances

1.pH low (acidosis) or high (alkalosis).

2.If pCO2 , is abnormal the problem is respiratory. If HCO3 - is

abnormal the problem is metabolic.

3. If pH is within the normal range, there is full compensation. If it

is outside the normal range, the body is partially compensating for
the problem.