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An acid-base diagram for human plasma, showing the effects on the plasma pH when P CO 2 in mmHg or Standard Base Excess (SBE) occur in excess or are deficient in the plasma [23] Acid–base imbalance occurs when a significant insult causes the blood pH to shift out of the normal range (7.32 to 7.42 [16]).
The lungs contribute to acid-base homeostasis by regulating carbon dioxide (CO 2) concentration. The kidneys have two very important roles in maintaining the acid-base balance: to reabsorb and regenerate bicarbonate from urine, and to excrete hydrogen ions and fixed acids (anions of acids) into urine.
One of the measures of kidney function is the glomerular filtration rate (GFR). Other tests that can assess the function of the kidneys include assessment of electrolyte levels such as potassium and phosphate, assessment of acid-base status by the measurement of bicarbonate levels from a vein, and assessment of the full blood count for anaemia.
The bicarbonate buffer system regulates the ratio of carbonic acid to bicarbonate to be equal to 1:20, at which ratio the blood pH is 7.4 (as explained in the Henderson–Hasselbalch equation). A change in the plasma pH gives an acid–base imbalance. In acid–base homeostasis there are two mechanisms that can help regulate the pH.
Intracellular pH is typically lower than extracellular pH due to lower concentrations of HCO 3 −. [9] A rise of extracellular (e.g., serum) partial pressure of carbon dioxide (pCO 2) above 45 mmHg leads to formation of carbonic acid, which causes a decrease of pH i as it dissociates: [10] H 2 O + CO 2 ⇌ H 2 CO 3 ⇌ H + + HCO 3 –
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Most of the carbonic acid then dissociates to bicarbonate and hydrogen ions. The bicarbonate buffer system is an acid-base homeostatic mechanism involving the balance of carbonic acid (H 2 CO 3), bicarbonate ion (HCO − 3), and carbon dioxide (CO 2) in order to maintain pH in the blood and duodenum, among other tissues, to support proper ...
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