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The renal compensation process usually takes a few days to complete as it is dependent upon changes in the reabsorption of bicarbonate. [4] End-staged renal diseases as well as chronic kidney diseases increase the overall risk of individuals developing pneumonia due to the interactions between the kidneys and the lungs. [ 3 ]
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 ...
A simple means of estimating renal function is to measure pH, blood urea nitrogen, creatinine, and basic electrolytes (including sodium, potassium, chloride, and bicarbonate). As the kidney is the most important organ in controlling these values, any derangement in these values could suggest renal impairment.
It is slower than the initial bicarbonate buffer system in the blood, but faster than renal compensation. Respiratory compensation usually begins within minutes to hours, but alone will not completely return arterial pH to a normal value (7.4). Winter's Formula quantifies the amount of respiratory compensation during metabolic acidosis. [8]
The functions of the kidney include maintenance of acid-base balance; regulation of fluid balance; regulation of sodium, potassium, and other electrolytes; clearance of toxins; absorption of glucose, amino acids, and other small molecules; regulation of blood pressure; production of various hormones, such as erythropoietin; and activation of vitamin D.
The bicarbonate buffer, consisting of a mixture of carbonic acid (H 2 CO 3) and a bicarbonate (HCO − 3) salt in solution, is the most abundant buffer in the extracellular fluid, and it is also the buffer whose acid-to-base ratio can be changed very easily and rapidly. [15]
Recall that the relationship represented in a Davenport diagram is a relationship between three variables: P CO 2, bicarbonate concentration and pH.Thus, Fig. 7 can be thought of as a topographical map—that is, a two-dimensional representation of a three-dimensional surface—where each isopleth indicates a different partial pressure or “altitude.”
The parameter standard bicarbonate concentration (SBC e) is the bicarbonate concentration in the blood at a P a CO 2 of 40 mmHg (5.33 kPa), full oxygen saturation and 36 °C. [13] Reference ranges for blood tests, comparing blood content of bicarbonate (shown in blue at right) with other constituents.