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Acid/base balance - kidney

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Physiology 3120
Tom Stavraky

Human Physiology Wednesday, December 9, 2009 “Renal VIII” Acid/Base Balance • Collecting duct is the region of the nephron for this • Hydrogen or bicarbonate will be secreted into the filtrate • Two types of CD cells  Type A intercalated cells  H secretors  CO 2nd water combin+ (with carbonic anh+drase) to produce hydrogen & bicarbonate  These cells use a H ATPase to pump H into filtrate  Bicarbonate is reabsorbed using a bicarbonate-chloride antiporter; also have a chloride channel on luminal membrane to secrete excess Cl  Also use K/H ATPase  Type B intercalated cells  HCO sec3etors  CO 2ransport occurs more on basolateral side where the blood is  Same step to produce hydrogen and bicarbonate  Same antiporter as before, but this time it’s on the luminal membrane; same Cl channel on opposite membrane as well (basolateral)  Hydrogen pumped out with ATPase and K/H ATPase • Causes of acid/base disturbances 1. Metabolic acidosis (excess acid)  Excessive breakdown of fats or certain amino acids  Ingestion of aspirin, methanol, or antifreeze 2. Respiratory acidosis  Not being able to expel CO 2roperly (hypoventilation)  Don’t get enough air, or respiratory depression 3. Metabolic alkalosis  Excessive loss of H ions due to vomiting  Ingestion of bicarbonate-containing antacids 4. Respiratory alkalosis  Too much CO (h2perventilation) • Kidney sy
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