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Cards (94)
What role do kidneys play in acid-base balance?
They regulate
plasma
[HCO3-]
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What happens to filtered HCO3- in the kidneys?
It is completely
reabsorbed
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Where is HCO3- freely filtered in the kidneys?
At the
glomerulus
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What do kidneys secrete to maintain acid-base balance?
H+
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What do protons associate with in urine?
Urinary buffers like
phosphate
and
ammonia
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How is HCO3- formed in renal tubules?
It can be newly formed in renal tubules
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What replenishes HCO3- lost by buffering nonvolatile acids?
Kidneys
form new HCO3-
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What types of acids do kidneys excrete?
Sulfate
and
phosphate
(non-volatile acids)
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What is the process of bicarbonate reabsorption in the nephron?
All
filtered
HCO3-
is reabsorbed
For every bicarbonate reabsorbed, one H+ is
secreted
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What enzyme is involved in the formation of carbonic acid in the proximal tubule?
Carbonic anhydrase
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What happens to carbonic acid in the proximal tubular cell?
It dissociates into
bicarbonate
and
proton
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What is the relationship between proton secretion and bicarbonate reabsorption?
For every proton secreted, one
bicarbonate
enters blood
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What happens to the secreted proton in the tubular lumen?
It associates with
filtered
bicarbonate to form
carbonic acid
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How much of the filtered bicarbonate is reabsorbed in the proximal tubule?
85%
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What are the two mechanisms that form new bicarbonate in the kidneys?
Phosphate buffer system
Ammonia buffer system
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What is the role of the phosphate buffer in bicarbonate formation?
It helps form new bicarbonate by buffering
H+
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How is acid phosphate excreted in urine?
As
titratable acid
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What happens to ammonium in the urine?
It is excreted as
ammonium chloride
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How does ammonia contribute to bicarbonate formation?
Ammonia binds to
protons
to form
ammonium
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What stimulates the tubular capacity to form ammonium?
Prolonged
acidosis
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What are the two types of ATPases involved in H+ secretion in the collecting duct?
H+ ATPase and
K+-H+
ATPase
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What is the summary of bicarbonate reabsorption and formation in the kidneys?
HCO3-
is
filtered
and reabsorbed
H+ is
secreted
to maintain balance
New HCO3- is formed via
phosphate
and
ammonia buffers
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What do secreted protons form with HPO4- in the collecting duct?
Acid phosphate
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What do beta-intercalated cells in the collecting duct do?
They secrete
HCO3-
in urine
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What happens during chronic alkalosis in the kidneys?
They
secrete
bicarbonate
lost in urine
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How is urinary acid loss quantified?
H+
in urine =
Acid phosphate
+
Ammonium
-
Urinary Bicarbonate
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What happens to H+ secretion during chronic acidosis?
Increased H+ secretion in
tubules
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What is the total production of fixed H+ in normal conditions?
50 mEq/day
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What is the effect of increased PaCO2 on H+ secretion?
It increases
carbonic anhydrase
activity
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How does hypokalemia affect H+ secretion in renal tubules?
It
stimulates
H+ secretion
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What is the relationship between metabolic acidosis and serum potassium levels?
Metabolic acidosis causes
hyperkalemia
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What happens to potassium levels during metabolic alkalosis?
It causes
hypokalemia
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How does hypokalemia affect pH levels?
It leads to
alkalosis
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What is the major intracellular cation?
K+
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How are K+ and H+ related?
K+ and H+ are closely related
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What is the plasma glucose level in diabetic ketoacidosis?
400 mg/dL
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What happens to K+ during insulin deficiency and hyperglycemia?
K+ shifts from ICF to ECF
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What is the result of increased serum K+ in diabetic ketoacidosis?
Hyperkalemia
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How do changes in pH affect serum K+ levels?
Changes in pH affect serum (ECF) K+ levels
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What is the effect of metabolic acidosis on serum potassium?
Hyperkalemia
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See all 94 cards
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