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Role of kidneys in acid base balance

  • The kidneys play a crucial role in maintaining the body's acid-base balance, a vital aspect of homeostasis, by regulating the pH of the blood.

  • The normal pH range of blood is tightly regulated between 7.35 and 7.45, and the kidneys contribute to maintaining this balance by excreting acid or base and reabsorbing bicarbonate (HCO3^-) from the urine.

Excretion of Hydrogen Ions

  • The kidneys help maintain acid-base balance primarily through the excretion of hydrogen ions (H+) in the urine. Nephrons, the functional units of the kidney, contain cells that can secrete H+ into the tubular fluid.

  • This process is essential for removing excess acid from the body.

  • The excretion of hydrogen ions is facilitated through several mechanisms:

1. Ammonia Buffering:

  • Process: Ammonia (NH3) binds with H+ to form ammonium (NH4+), which is excreted in urine.

2. Phosphate Buffering:

  • Process: Dihydrogen phosphate (H2PO4-) binds with H+ to form monohydrogen phosphate (HPO4^2-), which is excreted in urine.

Reabsorption and Production of Bicarbonate

1. Reabsorption:

  • Process: Most filtered bicarbonate is reabsorbed in the proximal tubule, helping maintain the body's base balance.

2. Production:

  • Process: Kidneys generate new bicarbonate through glutamine metabolism and the excretion of ammonium (NH4+) and titratable acids, which adds new bicarbonate to the blood.

Compensation for Acid-Base Imbalances

  • The kidneys respond to and compensate for imbalances in the body's acid-base status:

1. Metabolic Acidosis:

  • Response: The kidneys increase H+ excretion and bicarbonate reabsorption to raise blood pH.

2. Metabolic Alkalosis:

  • Response: The kidneys reduce H+ excretion and bicarbonate reabsorption to lower blood pH.


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