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Bone buffering of acid and base in humans
Jacob Lemann1, David A Bushinsky, L Lee Hamm
1Nephrology Section, Tulane University School of Medicine, 2601 St. Charles Ave., New Orleans, LA 70130-5927, USA. dr.jack@lemann.net
American Journal of Physiology. Renal Physiology
|October 9, 2003
Summary
Metabolic acid balance in humans is complex. When acid production changes, the kidneys don't fully compensate, leading to imbalances buffered by bone mineral, affecting calcium and potassium levels.
Area of Science:
- Physiology
- Nephrology
- Bone Metabolism
Background:
- Metabolic acid production and excretion in humans are not fully understood.
- Accurate measurement of acid-base balance is crucial for physiological studies.
- The relationship between acid balance and charge balance requires further clarification.
Purpose of the Study:
- To investigate the relationship between metabolic acid production and renal net acid excretion.
- To examine the role of bone buffering in acid-base homeostasis.
- To clarify the connection between acid balance and charge balance.
Main Methods:
- Experimental manipulation of acid production in healthy subjects.
- Measurement of renal net acid excretion.
- Analysis of acid-base and charge balance.
Main Results:
- Increased acid production led to positive acid balances, not fully matched by renal excretion.
- Positive acid imbalances were associated with negative charge balances due to bone buffering (Ca2+ loss).
- Decreased acid production (with KHCO3 or NaHCO3) resulted in negative acid balances (positive HCO3- balances) and positive charge balances, likely via bone mineral adsorption.
Conclusions:
- Renal net acid excretion does not precisely match changes in metabolic acid production.
- Bone buffering plays a significant role in maintaining acid-base balance by modulating charge balance.
- Charge balance provides insights into the mechanisms of acid-base regulation involving bone mineral.