Metabolic production and renal disposal of hydrogen ions

AbstractThe traditional approach to acid-base balance, namely, that the metabolism of certain dietary amino acids generates nonvolatile acids (H2SO4 HCl)1 and that this acid load is simply excreted in the urine in the form of titratable acid and ammonium (NH4+) is at best only partially correct, and is, in some respects, misleading. In fact, the metabolic generation of these nonvolatile acids is normally compensated within the body by metabolic processes which remove protons. In this discussion we shall describe these latter metabolic processes to clarify the biochemical basis underlying net acid elimination by the kidney. The discussion will be divided into three sections: the metabolic generation of nonvolatile acids, their metabolic consumption, and finally, the quantitative role of titratable acid excretion in this regard