Historical perspective on the role of the kidney in acid-base regulation
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1Division of Nephrology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. smogorze@usc.edu
Abstract:
Early observations on the acidity of normal urine by J. B. von Helmont (1527-1644) and on urine content of sulfate, phosphate and carbonate by J. J. Berzelius (1779-1848), followed by the studies of Bence Jones (1813-1878) on the connection between food, nutrition and urine acidity, pointed to the role of the kidney in regulation of acid-base status in humans and animals. The next important steps in this field of science were studies by F. Walter (1877) on decreased "alkali" in blood and increased ammonia in the urine of dogs after infusion into their blood of hydrochloric acid, and the observations of B. Naunyn (1939-1925) and O. Minkowski (1853-1931) on the presence of beta-hydroxybutyric acid in urine and on increased ammonia excretion in urine from patients with diabetic coma. Also it was found that patients with uremia had decreased titratable "alkali' in blood (R. von Jaksch 1855-1947) and reduced ability to excrete ammonia (W. W. Palmer and L. J. Henderson 1915). Finally, studies by R. F. Pitts (1908-1977) defined the role of the kidney in reabsorption of bicarbonate in the tubules and linked hydrogen secretion to sodium excretion in the urine.
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