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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 ...
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 ...
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.
Metabolic acidosis is a serious electrolyte disorder characterized by an imbalance in the body's acid-base balance.Metabolic acidosis has three main root causes: increased acid production, loss of bicarbonate, and a reduced ability of the kidneys to excrete excess acids. [5]
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]
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 ...
Acute respiratory acidosis occurs when an abrupt failure of ventilation occurs. This failure in ventilation may be caused by depression of the central respiratory center by cerebral disease or drugs, inability to ventilate adequately due to neuromuscular disease (e.g., myasthenia gravis, amyotrophic lateral sclerosis, Guillain–Barré syndrome, muscular dystrophy), or airway obstruction ...
Distal renal tubular acidosis with failure of H + secretion; Long-term use of a carbonic anhydrase inhibitor such as acetazolamide; Other causes [citation needed] Ingestion of ammonium chloride, hydrochloric acid, or other acidifying salts; The treatment and recovery phases of diabetic ketoacidosis