Disturbances In Acid-Base Balances

Disturbances In Acid-Base Balances


DISTURBANCES IN ACID-BASE BALANCES

  • Two types of disturbances – 
  • Acidosis.
  • Alkalosis.
  • Acidosis – 
  • Excessive acid accumulation/base depletion in body.
  • Alkalosis – 
  • Excess base accumulation/acid depletion.

REGULATION:

  • Most important regulatory buffer system – 
  • Bicarbonate buffer:
  • 2 components – HCO3 & CO2.
  • CO2 – Depends on respiratory activity.
  • HCO– Depends on renal mechanisms.

1. RESPIRATORY ACIDOSIS:

  • Due to CO2 retention.
  • Increased PCO2→ Causes decreased pH (acidosis).
  • Major compensatory mechanism – Renal compensation.

2. RESPIRATORY ALKALOSIS:

  • Due to hyperventilation.
  • Causes COwashout & decreased PCO2 → Increases pH (alkalosis).
  • Compensation mechanism – 
  • Renal compensation.
  • By increasing urinary HCO3 loss.

3. METABOLIC ACIDOSIS:

  • Due to decreased plasma HCO3.
  • Results in decreased pH (acidosis).
  • Also associated with increased renal ammonia production.
  • Increased ammonia in tubule → buffers augmented H+secretion.
Compensation mechanism:
  • Both respiratory & renal compensatory mechanisms involved.

3a. Respiratory compensation:

  • By hyperventilation → Increasing H+action on peripheral chemoreceptors.
  • This decreases pCO2 → Raises pH.

3b. Renal compensation:

  • By, 
  • Increased H+secretion.
  • Generation of new HCO3 ions.
  • Reabsorption of filtered HCO3 ions.

4. METABOLIC ALKALOSIS:

  • Due to increased HCO3 → Increases pH & causes alkalosis.
  • Both respiratory & metabolic compensation involved.
  • Limited respiratory compensation.

4a. Respiratory compensation:(Limited action)

  • Includes hypoventilation.
  • As increased pH inhibits peripheral chemoreceptors.
  • Results in CO2 retention → Decreases pH.

4b. Renal compensation:

  • Includes decreased H+secretion → Resulting in decreased HCO3 reabsorption.
Exam Question
 

DISTURBANCES IN ACID-BASE BALANCES

  • Metabolic acidosis is due to decreased plasma HCO3- which results in decreased pH and acidosis.
  • Also associated with increased renal ammoniogenesis, which increases amount of ammonia available in the tubule for buffering augmented H+ secretion.
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