Renal regulation of acid-base balance The biochemical processes involved in human metabolism result in an acid excess on a daily basis, due to dietary contribution to acid formation and intestinal loss of bases.1Both T, Zietse R, Hoorn EJ, et al. Everything you need to know about distal renal tubular acidosis in autoimmune disease. Rheumatol Int. 2014 Aug;34(8):1037-45. However, the kidneys maintain the acid base homeostasis by reabsorbing filtered HCO3 - and excreting H+ through the titration of urinary buffers and the excretion of ammonium.2Rodriguez Soriano J. Renal tubular acidosis: the clinical entity. J Am SocNephrol. 2002 Aug;13(8):2160-70 HCO3 - reabsorption Approximately 80% of the filtered HCO3 - is reabsorbed by the proximal tubule, while the thick ascending limb and distal convoluted tubule reabsorbs 16%, and the cortical duct reabsorbs the remaining HCO3 - (4%).3Koeppen BM. The kidney and acid-base regulation. AdvPhysiol Educ. 2009 Dec;33(4):275-81 Absorption of HCO3 - by cells…
Chronic kidney disease: An overview Chronic kidney disease (CKD) is a disorder which is associated with considerable health and economic burden.CKD involves age-related decline in renal function which can be further accelerated by co-associated hypertension,diabetes and obesity. In addition it is an independent risk factor for various comorbidities. Several studies have shown high prevalence of CKD globally; the disorder is known to affect 13·4% of the population. Women are reported to be more commonly affected than men.1Hill NR, Fatoba ST, Oke JL, et al. Global Prevalence of Chronic Kidney Disease - A Systematic Review and Meta-Analysis. PLoS One. 2016;11(7):e0158765. The natural history of CKD is known, although it is less well-studied in children.Once significant injury to the kidney occurs, progression towards end-stage renal disease is relentless irrespective of the underlying kidney disorder. Deterioration in renal function occurs at a faster rate in the high risk population compared to those at…
