ACID-BASE BALANCE

Fatima Tasneem Jimlok Mohammad Sali

FEU – Institute of Nursing
BSN003 / Group 11
 Normal function of body cells depends on regulation
of the hydrogen ion (H+) concentration within very
narrow limits.
 Acid-Base imbalances are frequently diagnosed with
Arterial Blood Gas.
Regulation of Acid-Base
balance
 The symbol pH refers to the negative logarithm of
the H+ concentration.
 A pH of 7.0 is neutral; an acidic solution has a pH
less than 7.0; and an alkaline solution has a pH
greater than 7.0
 Normal serum pH is 7.35-7.45
 Three physiologic systems act interdependently to
maintain a normal serum pH
2. Chemical buffering of excess acid or base by
buffer systems in the blood plasma and in cells.
3. Excretion of acid by the lungs
4. Excretion of acid or regeneration of base by the
kidneys.
 Modulation of serum pH by
buffer systems
 Chemical buffers are solutions that resist changes in pH
 A buffer is made up of a weak acid and its conjugate
base.
 The most important extracellular buffer is the HCO3
−/H2CO3 system, described by the equation:

H+ + HCO3 − ↔H2CO3 ↔ CO2 + H2O

 The organic acids formed during cellular energy
metabolism are strong acids.
 Example of buffering reactions
Strong acid buffered:
HCL + (H2CO3/NaHCO3) → H2CO3 + NaCl
Strong base buffered:
NaOH + (H2CO3/NaHCO3) →NaHCO3 + H2O
• Proteins such as hemoglobin in RBCs and albumin
in the plasma are quantitatively the most important
blood buffers.
• Negatively charged ions, such as phosphate within
body cells and carbonate within bones, are important
intracellular buffers.
• Buffer systems act instantly to minimize the impact
of adding strong acids or bases to body fluids.
 The concentrations of bicarbonate ions and of
carbonic acid are controlled by two independent
physiological systems.
 Carbonic acid concentration is controlled by the
lungs while bicarbonate ions is through the lungs.
Regulation of volatile acids by
the lungs
 Volatile acids are acids that can be converted to
gases.
 During normal ventilation (breathing), the lungs
exhale large quantities of “potential” acid in the form
of CO2
 CO2 diffuses from body cells into the blood, where it
may combine with water to form H2CO3 , which then
dissociates into its component ions: H+ and HCO3-.
This hydrolysis reaction, which is reversible, is
shown as follows:
H2O + CO2 ↔H2CO3 ↔ HCO3- + H+
 The law of mass action states that the rate of a
chemical reaction is directly proportional to the
molecular concentrations of the reacting substances.
 The rate and direction of the hydrolysis reaction are
determined by (1) the addition of substrate or (2) the
removal of end product.
 In the lungs, CO2 diffuses along its concentration
gradient from the plasma to the alveoli, from which it
is exhaled.
 Regulation of fixed acids and bicarbonate
by the kidneys
 Fixed acids are acids that cannot be converted to
gases, thus should be eliminated in the urine.
 These fixed acids include the ff: Sulfuric, phosphoric,
ketones, lactic acid and occasionally, ingested toxins
such as salicylates, drugs and methanol.
 The kidneys regulate serum pH by secreting H+ into
the urine and by regenarating HCO3- for reabsorption
in the blood.
 URINARY BUFFER SYSTEMS
 The three principal buffer systems in renal tubules
are the bicarbonate, ammonia and phosphate
(titratable acid) systems.
3. Bicarbonate buffer
4. Ammonia buffer
5. Phosphate buffer
Bicarbonate Buffer
 H+ is secreted into the tubular lumen by tubular cells
in countertransport with sodium.
 The combination of H+ with filtered bicarbonate
regenerates CO2 in a reversal of the hydrolysis
reaction.
 This CO2 is reabsorbed into tubular cells, where
hydrolysis proceeds.
GLOMERULUS
2
HCO3-
+ 1
3 H+ Na+
Na+

H2CO3 H+ 6
+
5 HCO3-

H20+C02 CO2+H20 H2C03 HCO3-

4
PERITUBULAR
TUBULAR FLUID RENAL TUBULAR CELLS CAPILLARY
Ammonia Buffer
 Depends on the generation of ammonia (NH3) from
amino acids in renal tubular cells.
 NH3 diffuses into the tubular lumen, where it may
combine with secreted H+ to form ammonium
(NH4+)
 NH4+ is excreted in the urine in combination with Cl-
from NaCl
GLOMERULUS

Cl-
1
H+
3 +
NH3
2
Cl-+NH4 NH3 Glutamine
4
NH4Cl

RENAL TUBULAR PERITUBULAR

TUBULAR FLUID CELLS CAPILLARY
Phosphate Buffer
 Results in the formation of weak acids that are
excreted in the urine.
 GLOMERULUS
2
HPO42- Na+

HPO42- + H+ 1

3
H2PO4- + Na+

4
NaH2PO4

RENAL TUBULAR PERITUBULAR

TUBULAR FLUID CELLS CAPILLARY