[Renal adaptations to acid-base disorders].
Alterations in acid-base status affect renal hemodynamics and tubular function. GFR is reduced both in acute acidosis and alkalosis. Tubular functional adaptation to acute acidosis includes an acceleration in proximal acidification, induced by the increase in Pco2 and luminal bicarbonate concentration and a stimulated ammonia production, induced by low pH. Alteration in distal bicarbonate reabsorption is also an important determinant of the net acid excretion. Renal functional alterations in acute alkalosis include a reduction in GFR and a stimulated bicarbonate secretion in the cortical collecting duct. Proximal acidification is almost unchanged during acute alkalosis but reportedly accelerates after at least 3 weeks of maintained alkalosis. Renal adaptation during chronic phase of acid-base disorders differs from that during the acute phase.
Ushiogi
Y
Y
First Department of Internal Medicine, School of Medicine, Kanazawa University.
Takabatake
T
T
D000138:Acidosis / Q000503:physiopathology*; D000471:Alkalosis / Q000503:physiopathology*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*