Kidney can acidify urine down to a pH of about 4.1. This is not acid enough to get rid of the daily fixed acid load of about 80 mEq/day. Therefore buffers are essential for survival. Phosphate buffer is limited due to low plasma concentration. Ammonium buffer is unlimited due to unlimited supply of glutamine.
Contraction alkalosis
K homeostasis
Handy Tools
Respiratory acidosis or alkalosis = rule of 12
acute: if PCO2 is changed by 12, the pH should change by 0.1
e.g., PCO2 = 52, pH = 7.3
PCO2 = 28, pH = 7.5
if pH does not follow this rule, there is compensation (needs days to happen)
Metabolic acidosis or alkalosis = rule of 6
acute: if HCO3 is changed by 6, the pH should change by 0.1
e.g., HCO3 = 18, pH = 7.3
HCO3 = 30, pH = 7.5
if pH does not follow this rule, there is compensation (needs seconds to happen)
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