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Renal compensation is a mechanism by which the kidneys can regulate the plasma pH. It is slower than respiratory compensation , but has a greater ability to restore normal values. Kidneys maintain the acid-base balance through two mechanisms: (1) the secretion of H + ions into the urine (from the blood) and (2) the reabsorption of bicarbonate ...
Systemic effects include increased loss of sodium, potassium, and water in the urine, secondary to the drug's effects on the renal tubules, where valuable components of filtered blood are re-absorbed in the kidney. Arterial blood gases may show a mild hyperchloremic metabolic acidosis. [5] Methazolamide is also a carbonic anhydrase inhibitor.
Renal tubular acidosis (RTA) is a medical condition that involves an accumulation of acid in the body due to a failure of the kidneys to appropriately acidify the urine. [1] In renal physiology, when blood is filtered by the kidney, the filtrate passes through the tubules of the nephron, allowing for exchange of salts, acid equivalents, and other solutes before it drains into the bladder as urine.
Intravenous sodium bicarbonate is indicated in the treatment of metabolic acidosis, such as can occur in severe kidney disease, diabetic ketoacidosis [citation needed], circulatory insufficiency, extracorporeal circulation of blood, in hemolysis requiring alkalinization of the urine to avoid nephrotoxicity of blood pigments, and certain drug intoxications, such as by barbiturate overdose ...
Alkalinizing agents are drugs used to manage disorders associated with low pH. For example, they may be used to treat acidosis due to kidney failure. Used for oral or parenteral therapy, sodium bicarbonate is the commonly preferred alkalinizing agent. [1] Others include potassium citrate, calcium carbonate, sodium lactate and calcium acetate. [2]
Chronic metabolic acidosis commonly occurs in people with chronic kidney disease (CKD) with an eGFR of less than 45 ml/min/1.73m 2, most often with mild to moderate severity; however, metabolic acidosis can manifest earlier on in the course of CKD. Multiple animal and human studies have shown that metabolic acidosis in CKD, given its chronic ...
Compensation occurs if respiratory acidosis is present, and a chronic phase is entered with partial buffering of the acidosis through renal bicarbonate retention. [ citation needed ] However, in cases where chronic illnesses that compromise pulmonary function persist, such as late-stage emphysema and certain types of muscular dystrophy ...
Bicarbonate concentration is also further regulated by renal compensation, the process by which the kidneys regulate the concentration of bicarbonate ions by secreting H + ions into the urine while, at the same time, reabsorbing HCO − 3 ions into the blood plasma, or vice versa, depending on whether the plasma pH is falling or rising ...