Renal Acid Base Regulation Flashcards
In the bicarbonate buffer system, the enzyme, , catalyzes the reaction between carbon dioxide with water to form carbonic acid.
Carbonic Anhydrase
NH3 in the (section of the nephron
) binds to hydrogen ions and prevents the pH from falling.
Proximal Tubule
In the kidney, most of the bicarbonate is reabsorbed in the (section of the nephron) .
Proximal Tubule
The counter-transporter secretes hydrogen ions into the lumen of the proximal tubule.
Na H
The system is an acid-base homeostatic mechanism involving the balance of carbonic acid, bicarbonate ion, and carbon dioxide in order to maintain pH.
Bicarbonate Buffer System
In renal failure where large amounts of HCO3- is lost, it can lead to metabolic (acidosis/alkalosis) .
ACIDOSIS
The two organs that plays a major role in maintaining pH in the body are .
LUNGS
KIDNEYS
Decreased respiratory rate can cause retention of CO2 leading to respiratory (acidosis/alkalosis) .
ACIDOSIS
A normal blood pH is between .
7.35-7.45
As PCO2 increases in the blood, the pH (increases/decreases) .
Decreases
As the HCO3− level increases in the blood, the pH (increases/decreases) .
Increases
Increased reabsorption is a delayed compensatory response to respiratory acidosis.
renal HCO3
Using the Winters formula for metabolic acidosis, if measured Pco2 is greater than predicted , there is a concomitant respiratory acidosis.
PCO2
The initial disturbance of respiratory acidosis is an increased Pco2 concentration, followed by a compensatory response of (increased/decreased) HCO3-.
INCREASED
An acidemia or pH less than with an increased pCO2 is classified as respiratory acidosis.
7.35
Airway obstruction, chronic lung disease, opioids, sedatives, and weakening of respiratory muscles cause and therefore respiratory acidosis.
HYPOVENTILATION
The initial disturbance of respiratory acidosis is an increased partial pressure of , followed by a compensatory response of increased HCO3-.
CO2
(Hyperventilation/Hypoventilation) is an immediate compensatory response to metabolic acidosis.
HYPERVENTILATION
Metabolic acidosis is one of the consequences of renal .
FAILURE
Consequences of RENAL FAILURE
MAD HUNGER
Metabolic Acidosis Dyslipidemia HyperKALEMIA Uremia - clinical syndrome marked by increased BUN -nausea and anorexia -pericarditis -asterixis -encephalopathy -platelet dysfunction
Na and H20 retention (HF, PE, HPN)
Growth retardation
EPO failure (ANEMIA)
Renal osteodystrophy
and beta-hydroxybutyric acid are metabolites of fat metabolism that can cause metabolic acidosis when they accumulate.
Acetoacetic Acid
The initial disturbance of metabolic acidosis is a decreased HCO3- concentration, followed by a compensatory response of decreased .
PCO2
Predicted respiratory compensation for a simple metabolic acidosis can be calculated using the .
Winters formula
A metabolic acidosis is defined by an acidemia (pH less than 7.35) with a HCO3- less than mEq/L.
20 mEq/L
The Winters formula used to predict the respiratory compensation for metabolic acidosis is .
PCO2 = 1.5 (HCO3) + 8 + 2
The initial disturbance of metabolic acidosis is a decreased concentration, followed by a compensatory response of decreased Pco2 which helps to raise the pH back toward the normal range.
HCO3
Respiratory alkalosis is a consequence of the response to (high/low) altitude.
HIGH
The initial disturbance of respiratory alkalosis is a decreased concentration.
pCO2
The response to high altitude has an increased renal excretion of to compensate for respiratory alkalosis.
HCO3
Pulmonary emboli produce respiratory alkalosis once the body compensates for the .
Decrease in pulmonary blood flow
Toxic doses of cause respiratory alkalosis early, but transitions to mixed metabolic acidosis-respiratory alkalosis.
ASPIRIN
Respiratory alkalosis is an alkalemia with a pH greater than and a decreased Pco2 .
7.45
Decreased renal reabsorption is a delayed compensatory response to respiratory alkalosis.
HCO3
Hypertension, hypokalemia, and (acid-base disorder) are findings in Conn syndrome.
Metabolic Alkalosis
CONN SYNDROME
- hypokalemia
- HPN
- metabolic alkalosis
The initial disturbance of metabolic alkalosis is an increased concentration, followed by a compensatory response of increased Pco2.
HCO3
Renal medication) , thiazide diuretics, vomiting, antacid use, and hyperaldosteronism are all causes of metabolic alkalosis.
Loop diuretics
Alkalosis is when the pH is greater than .
7.45
is a diuretic used to alkalinize the urine or treat metabolic alkalosis as it inhibits carbonic anhydrase.
Carbonic Anhydrase (Acetazolamide)
(Hyperventilation/Hypoventilation) is an immediate compensatory response to metabolic alkalosis.
Hypoventilation
Hyperaldosteronism causes (acid-base disorder)
Metabolic Alkalosis
Excessive vomiting results in (acid-base disorder) , secondary to vomiting of gastric acid and subsequent volume contraction
Metabolic alkalosis
Bulimia nervosa is associated with (acid-base disorder) .
Metabolic Alkalosis
All renal tubular defects result in metabolic alkalosis, except for .
Fanconi Syndrome
