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The Kidney in Acid-Base Balance

Arch Intern Med. 1965;116(5):681-688. doi:10.1001/archinte.1965.03870050035007.
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Introduction  SUDDEN CHANGES in body acid-base balance are neutralized by the blood buffers within seconds. The lungs partially compensate for acidosis or alkalosis through increased or decreased excretion of CO2 in a matter of minutes. The kidneys, however, are ultimately responsible for maintaining body pH within narrow limits. Their corrections are relatively slow, taking place through increased or decreased excretion of H+ or Image not available., over a period of hours to days.In carnivorous and omnivorous animals like man, metabolism produces an excess of acid. (The term acid is here used to mean a proton or H+ donor in accord with the Brønsted concept of acids and bases). Carbohydrate metabolism, when completed aerobically, produces H2O and CO2 which can be eliminated by the lungs. However, phosphoric acid is continually formed by metabolic oxidation of nucleoproteins and phospholipids, while sulfuric acid is formed by oxidation of protein.1 Somewhere between 20-100 mEq


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