Lecture 31 – Renal Physiology VI

Once it gets lower ions wont move because the proton

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once it gets lower, ions wont move because the proton channels cannot work against  the gradient the H transporter cannot overcome the electrochemical gradient to minimize deceases in pH, secreted H ions are buffered in PT, this is done by bicarbonate in DT and CD, very little bicarbonate remains because most is reabsorbed
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however, phosphate is freely filtered in the glomerulus, and so the lumen of the DT and  CD, protons are buffered by phosphates OVERALL: there are two primary effects in DT and CD of importance in pH regulation Newly synthesized bicarbonates added to plasma Protons added to tubular filtrate, and are almost certainly excreted because you cant get  them back after the distal tubule Glutamate metabolism in the PCT This is only when there is severe acidosis that causes a significant drop from 7.4 Can happen as a result of hypoventilation (lung diseases, ketone metabolism, diarrhea) Glutamine, an AA, is transported from both the tubular nd peritubular fluid into the  epithelial cell Glutamine is catabolized yielding bicarbonate and ammonia The bicarbonate moves into the peritubular fluid either by cotransport with NA or counter  transport with Cl It stays in the body The bicarbonate is not reabsorbed – newly synthesized The ammonia is converted to ammonium which si moves into the tubular fluid by  counter transport with Na and excreted The overall effect is that a newly synthesized bicarbonate is added to the plasma and a  H is secreted in the form of ammonium Normal pH is of arterial blood is 7.4 – use Henderson-Hasslebach to show what the ratio  of bicarbonate and CO2 should be this is the ratio that is being regulated: about 20:1 the kidneys regulate bicarbonate and the respiratory system regulates CO2 ***know how each of these systems do that
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chronic indigestion patients take a lot of TUMS and magnesium – if you take too many  you will get alkalosis by either of these mechanisms
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when protons are removed or irreversibly bound  respiratory compensation is decreased inhalation do increase pCO2 kidneys will increase acidity by excreted more bicarbonate and reabsorbing more H
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