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Renal handling

  • Identify the normal range of blood pH values. Distinguish between CO2-derived (volatile acid) and nonvolatile acids. Describe the roles of buffers and renal adjustments after a sudden gain or loss of acid.
  • Identify the sites of acid-base transport in the kidney.
  • Describe renal tubular secretion of protons, the importance of titratable acid, and the roles of ammonium and K in pH regulation. Distinguish between the reclamation of filtered bicarbonate and the formation of new bicarbonate. Describe the molecular mechanism of action of carbonic anhydrase inhibitor diuretics that affects renal regulation of pH.

Protons are released by acids and accepted by bases. pH is a measure of the amount of hydrogen protons in a solution. The more basic the solution, the higher the pH. The more acidic, the lower. The relationship of hydrogen proton concentration is related by the equation:

<math>pH = -\log_{10}{[H^+]}</math>

The normal pH of extracellular fluid and arterial plasma ranges from 7.35 to 7.45, or a concentration of approximately 40 nM. The major extracellular fluid buffer, however, is bicarbonate, which is present at quantities of approximately 25 mM.

The kidneys can compensate for acidemia or alkalemia by varying the pH of urine, ranging it between 4.5 and 8.5. Also, the kidneys can regulate blood pH by excreting protons derived from non-volatile acids, which allows for the control of plasma bicarbonate concentrations.