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Control of Acid Excretion by the Kidney

Control of Acid Excretion by the Kidney Under normal conditions the renal regulation of acid excretion is closely coupled to hydrogen ion intake, so that plasma bicarbonate concentration is maintained at stable levels despite wide variations in dietary acid inges­ tion. With larger hydrogen ion loads resulting from altered intake or pro­ duction, or with abnormalities in CO2 elimination by the lungs (respiratory acid-base disorders), renal acid excretion responds in a fashion that tends to defend the maintenance of a normal systemic pH. The renal regulation of hydrogen ion homeostasis can be viewed in terms of two distinct, yet intimately linked, processes-hydrogen ion (acid) excre­ tion and secretion. Acid excretion provides a renal mechanism to modify the body alkali stores. Quantitatively, acid excretion is equivalent to the sum of urinary titratable acid and ammonium, minus the bicarbonate lost in the urine. Hydrogen ion secretion includes the quantity of filtered bicar­ bonate reabsorbed by the nephron in addition to the amount of acid ex­ creted. Functionally, it determines the plasma bicarbonate concentration that can be sustained. Under normal conditions more than 98% of hydro­ gen ion secretion is expended in bicarbonate reabsorption, with only a minor fraction accounting for acid excretion. Despite this quantitative dis­ crepancy http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annual Review of Medicine Annual Reviews

Control of Acid Excretion by the Kidney

Annual Review of Medicine , Volume 31 (1) – Feb 1, 1980

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References (32)

Publisher
Annual Reviews
Copyright
Copyright 1980 Annual Reviews. All rights reserved
Subject
Review Articles
ISSN
0066-4219
eISSN
1545-326X
DOI
10.1146/annurev.me.31.020180.000343
pmid
6994617
Publisher site
See Article on Publisher Site

Abstract

Under normal conditions the renal regulation of acid excretion is closely coupled to hydrogen ion intake, so that plasma bicarbonate concentration is maintained at stable levels despite wide variations in dietary acid inges­ tion. With larger hydrogen ion loads resulting from altered intake or pro­ duction, or with abnormalities in CO2 elimination by the lungs (respiratory acid-base disorders), renal acid excretion responds in a fashion that tends to defend the maintenance of a normal systemic pH. The renal regulation of hydrogen ion homeostasis can be viewed in terms of two distinct, yet intimately linked, processes-hydrogen ion (acid) excre­ tion and secretion. Acid excretion provides a renal mechanism to modify the body alkali stores. Quantitatively, acid excretion is equivalent to the sum of urinary titratable acid and ammonium, minus the bicarbonate lost in the urine. Hydrogen ion secretion includes the quantity of filtered bicar­ bonate reabsorbed by the nephron in addition to the amount of acid ex­ creted. Functionally, it determines the plasma bicarbonate concentration that can be sustained. Under normal conditions more than 98% of hydro­ gen ion secretion is expended in bicarbonate reabsorption, with only a minor fraction accounting for acid excretion. Despite this quantitative dis­ crepancy

Journal

Annual Review of MedicineAnnual Reviews

Published: Feb 1, 1980

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