Bicarbonate Flashcards

1
Q

what’s the formula that makes bicarbonate

A

water + CO2 = HCO3 + H+

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2
Q

what does pH approximate

A

HCO3 / pCO2

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3
Q

What the kidney does

A
• Bicarbonate filtration
• Bicarbonate reabsorption
• Bicarbonate regeneration by: 
– Titratable acid excretion
– Ammonium excretion
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4
Q

bicarbonate regeneration is by two processes

A

titrate acid excretion

ammonium excretion

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5
Q

buffers in urine

A
  • urate
  • creatinine
  • beta-hydroxybutyrate
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6
Q

ammonium excretion

A

Glutamine - taken up by renal tubule, converted to glucose or co2 and water and ammonium is the by product which is excreted into the urine and this process uses up protons

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7
Q

where glutamine formed

A

liver and the muscles and is triggered by a decrease in pH

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8
Q

Respiratory acidaemia

A
  1. Rise in pCO2
  2. Parallel change inside the renal tubule cells
  3. Intracellular acidaemia
  4. Increases uptake & use of glutamine & hence ammonium excretion
  5. Increasing bicarbonate regeneration
  6. Low intracellular pH increases tubular proton secretion and ensures optimum reabsorption of bicarbonate
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9
Q

Respiratory alkalaemia

A
  1. Fall in pCO2
  2. Parallel change inside the renal tubule cells
  3. Intracellular rise in pH
  4. Proton secretion falls
  5. Bicarbonate reabsorption rfalls
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10
Q

What happens when kidney function is impaired?

A
  • AKI & CKI
  • Damage to glomerulus & tubule
  • Will result in metabolic acidaemia
  • Decrease in ammonium secretion by tubule
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