Robert F. Pitts, M.D., F.A.C.P.
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The kidneys subserve three roles in the regulation of acid-base balance of the body fluids: the reabsorption of bicarbonate from the glomerular filtrate; the titration of fixed urinary buffers from their alkaline to their acid forms; and the secretion of the free base, ammonia. These three processes are all dependent on a single renal mechanism of exchange of H+ ions of tubular cells for Na+ ions of tubular fluid. They accomplish the stabilization of the plasma and extracellular concentration of bicarbonate within limits of 24 to 28 mEq/liter.
Of the processes that restore depleted reserves of bicarbonate to normal, secretion
Pitts RF. The American College of Physicians Award Lecture: Role of Ammonia in the Renal Regulation of Acid-Base Balance.. Ann Intern Med. ;72:775. doi: 10.7326/0003-4819-72-5-775_1
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Published: Ann Intern Med. 1970;72(5):775.
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