Title: RENAL TUBULAR NET ACID (NA) EXCRETION: INTERPRETATIONS FROM POTASSIUM IMBALANCE
Abstract: This chapter discusses that the kidney contributes to the overall acid-base balance in three ways: (1) reclamation of filtered bicarbonate, mainly in the proximal tubule, (2) excretion of bound hydrogen ions measured as titratable acid (TA), and (3) excretion of hydrogen ions which are bound to ammonia and appearing in final urine as ammonium ions. The amount of free hydrogen ions in final urine is quantitatively negligible. The reclamation of bicarbonate in the proximal tubule takes place via a hydrogen ion secretion by the renal cells. This secretion does not contribute to the elimination of excess acid in the body, but helps to conserve filtered alkali, that is, phosphate and bicarbonate. If the appearance of net acid (NA) in final urine reflects the necessity of getting rid of excess acid, it is expected that the elimination of TA and ammonium ions would occur synergistically. The chapter explains that this is not the case during disturbances in potassium balance. The data presented in the chapter suggests that factors other than the maintenance of a normal acid-base status in the body are responsible for the NA excretion by the kidney.
Publication Year: 1981
Publication Date: 1981-01-01
Language: en
Type: book-chapter
Indexed In: ['crossref']
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