Renal and Fluid-Electrolyte Disorders

Abstract

An acidosis is any process that tends (in the absence of buffering or compensation) to cause the accumulation of hydrogen ions (H⁺). If the pH of the blood is lower than normal (<7.35), acidemia is present. Similarly, any process that tends to cause the accumulation of bicarbonate (HC0₃) is an alkalosis. An elevated blood pH (>7.45) is referred to as alkalemia. When the acid-base disturbance arises as a result of changes in the carbon dioxide tension (PCO₂) of the blood, a respiratory process is present. Conversely, when the acid-base disturbance occurs as a result of accumulation of nonvolatile acids or loss of HCO₃ (or substances metabolized to HCO₃), a metabolic process is present. Acidosis and alkalosis can be either primary or compensatory for a different acid-base problem.