PGY300Renallec7 copy

PGY300Renallec7 copy - RENAL REGULATION OF ACID-BASE...

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RENAL REGULATION OF ACID-BASE BALANCE PHYSIOLOGY 300 DR. JOHN A. KRASNEY
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READING Chapter 20, pages 663-671 Animations: Acid-Base Homeostasis pages 1-60.
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Acid-Base Balance Acid-Base Balance means Regulation of ECF [H + ]. • [H + ] = PCO 2 / [HCO 3 - ] pH = - log of [H + ] • pH = [HCO 3 - ] / PCO 2
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pH Plasma pH is regulated at 7.4 pH 7.4 = 0.00004 meq/ L [H + ] • CO 2 is a volatile acid. Resting metabolism produces 12,500 meq of H + per day from CO 2 . Urine pH ranges from 4.5 to 8.5
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Carbonic Anhydrase • CO 2 + H 2 O H 2 CO 3 H + + HCO 3 - This reaction is catalyzed by carbonic anhydrase. Mass Action Carbonic anhydrase is present in kidney, lung and erythrocytes as well as stomach, pancreas and intestine.
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Buffers A buffer minimizes the change in pH when H + is added to a solution. Intracellular Buffers Hemoglobin: H + + Hb HHb Protein: H + + Pr - HPr Extracellular Buffers Bicarbonate, Phosphate, Ammonia.
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Extracellular Buffers Bicarbonate is the most important ECF buffer. The kidneys conserve bicarbonate. The kidneys filter about one pound of bicarbonate (baking soda) per day. Most of this bicarbonate is reabsorbed. Phosphate comes from ATP, ADP and AMP. Ammonia is formed within the renal tubules. Creatinine, uric acid
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Kidney Buffers When pH = pKa then there is a 50% mix of both forms of the buffer pair. • HCO 3 - / CO 2 pKa = 6.1 • HPO 4 2- / H 2 PO 4 - pKa = 6.8 (kidneys reabsorb phosphate) Creatinine pKa = 5.0 Urate/ Uric acid pKa = 5.8 • NH 3 / NH 4 + pKa = 9.2
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Reabsorption of Bicarbonate
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PGY300Renallec7 copy - RENAL REGULATION OF ACID-BASE...

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