Acidosis and Alkalosis

Respiratory acidosis PCO2 t Respiratory alkalosis PCO2 i Metabolic acidosis [HCO 3] i Metabolic alkalosis [HCO 3] f 

Normally everything is in balance. The lungs have the numerator (PCO2), and the kidneys have the denominator ([HCO 3]). The amount of CO2 produced by metabolism is balanced by the amount of CO2 blown off by the lungs and let go by the kidney. It s the same way with the other metabolic acids—they leave the body as CO2 or they are excreted by the kidneys. If everything always stayed in balance, you wouldn t have to learn all this—but as usual it doesn t, and you do. 

When blood pH is not normal, something must not be working correctly or the capacity of the system must have been exceeded. Using the magic equation 

The conclusion—respiratory acidosis must be compensated by metabolic alkalosis in order to return the pH to normal. The following table summarizes all the possibilities. Note that the directions of the arrows are always the same for PCO2 and [HCO3]. Metabolic is always compensated by respiratory (and vice versa), and acidosis is always compensated by alkalosis. 

Respiratory alkalosis pCOai [H+] i [HCO3] i Metabolic acidosis 

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Regulator mechanisms of hemoglobin oxygen affinity in acidosis and alkalosis. J Clin Invest (1971), 50,... 

Respiratory acidosis and alkalosis result from primary disturbances in the arterial carbon dioxide (C02) levels. Metabolic compensation of respiratory disturbances is a slow process, often requiring days for the serum HC03 to reach the steady state. 

Under normal circumstances the arterial pH is tightly regulated between 7.35 and 7.45. Acidemia is an abnormally low arterial blood pH (less than 7.35) while acidosis is a pathologic process that acidifies body fluids. Similarly, alkalemia is an abnormally high arterial blood pH (less than 7.45) while alkalosis is a pathologic process that alkalinizes body fluids. As such, although a patient can simultaneously have acidosis and alkalosis, the end result will be acidemia or alkalemia. 

Henderson-Hasselbalch Equation Titration Curves p/—Isoelectric Point The Bicarbonate Buffer Imbalance in Blood pH Acidosis and Alkalosis... 

The pK value indicates the pH range in which the dissociation of the H" occurs. More specifically, the pK is the pH at which the group is 50% dissociated, or half of it is in the acid form and half in the base form. These values of pK are used in determining the net charge a substance (amino acid, protein, drug) will have in the body and which ones will act as good buffers to keep the pH constant, and to understand pathologic states of acidosis and alkalosis. 

This drug exhibits strong diuretic action during both acidosis and alkalosis. It is used for arterial hypertension, in edematous syndromes of various genesis, congestive effects in cardiovascular insufficiency, nephrosis and nephritis, and toxicosis. It is especially recommended for hypertonic illnesses. It lowers intraocular pressure in a number of cases. Synonyms of this drug are clotride, diupres, diuril, and others. 

Acidosis and alkalosis are infrequent. Metabolic acidosis is a side effect of acetazolamide therapy and is due to bicarbonate loss in the PCT. All the K+-sparing diuretics can cause metabolic acidosis by H+ retention in the cells of the collecting duct. Metabolic alkalosis is associated with the loop and thiazide drugs. Reflex responses to volume depletion cause reabsorption of HCO-3 in the PCT and H+ secretion in the collecting tubule. 

Bicarbonate buffer system, acidosis, and alkalosis Radioisotopes, nuclear medicine Cell crenation/rupture Ion transport... 

The following clinical terms are used to describe the acid-base status. Addemia is defined as an arterial blood pH <7.35 d.nd alkalemia indicates an arterial blood pH >7.45. Acidosis and alkalosis refer to patliological states that lead to acidemia or alkalemia. For example, in common acid-base disorders... 

Miller P, Peers C, Kemp PJ. 2004. Polymodal regulation of hTREKl by pH, arachidonic acid, and hypoxia Physiological impact in acidosis and alkalosis. Am J Physiol Cell Physiol 286 C272-C282. 

Sh iro JI, Kaehny WD. Pafiiogenesis and management of metaboUc acidosis and alkalosis. In Schrier RW, ed. Renal and Electrolyte Disorders, 5th ed. Philadelphia, Lippincott, Williams Wilkins, 1997 130—171. 

Davies BMA, Yudkin J. 1952. Studies in biochemical adaptation. The origin of urinary ammonia as indicated by the effect of chronic acidosis and alkalosis on some renal enzymes in the rat. Biochem J 52 407-412. 

Acidosis and alkalosis arc clinical terms which define the primary acid-base disturbance. They can be used even when the 1H 1 is within the normal range, i.e. w hen the disorders are fully compensated. The deHnitions are ... 

Arieff AI, Kerian A, Massry SG DeLima J. (1976). Intracellular pH of brain alterations in acute respiratory acidosis and alkalosis. Am J Physiol 230, 804-812. 

Blood pH is normally in the range of 7.35-7.45. Three systems cooperate to maintain the pH in this narrow range, objective 6 (Section 15.6), Exercise 15.26. Acidosis and alkalosis exist when the blood pH becomes lower or higher, respectively, than these values. 

Needham A. Comparative and Environmental Physiology Acidosis and Alkalosis. 2004. 

Needham A. Comparative and Environmental Physiology Acidosis and Alkalosis. 2004. Pagana KD, Pagana TJ. Mosby s Manual of Diagnostic and Laboratory Tests, 3rd ed. St. Louis Mosby Elsevier, 2006. 

Metabolic Acidosis and Alkalosis Tubular Acidosis Proximal Tubular Acidosis... 

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