Acidosis and bone.
Acidosis and bone.
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DOI：
10.1007/978-1-84882-978-7_23
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发表时间：
1994
期刊：
影响因子：
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通讯作者：
D. Bushinsky
中科院分区：
文献类型：
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作者：
D. Bushinsky
人体代谢导致每天产生约1.1 mmol/kg的酸（质子，H+），这被称为内源性酸产生。1，2在腹泻、糖尿病酮症酸中毒和乳酸酸中毒等疾病期间会产生额外的内源性酸。这种额外的酸导致全身pH值降低，称为代谢性酸中毒。代谢性酸中毒的生理反应是迅速增加细胞外液pH值至生理中性7.40，以维持最佳细胞功能。1代谢性酸中毒的稳态反应包括首先缓冲酸，然后增加呼吸频率以降低二氧化碳分压（Pco 2），最后肾脏排泄额外的酸。最初的步骤，缓冲额外的酸，是至关重要的立即恢复到中性pH值允许保存生命。最后一步，肾排泄的酸，开始后几个小时的酸挑战，并在几天后完成。肾脏排酸依赖于正常的肾功能;随着年龄的增长，我们排酸的能力下降，人类变得轻微，但显着，更多的酸。
Human metabolism leads to the production of ∼1 mmol/kg of acid (protons, H+) per day, which is termed endogenous acid production.1,2Additional endogenous acid production occurs during disorders such as diarrhea, diabetic ketoacidosis, and lactic acidosis. This additional acid results in a reduction of systemic pH, which is termed metabolic acidosis. The physiologic response to metabolic acidosis is to rapidly increase extracellular fluid pH toward the physiologic neutral of 7.40 to maintain optimal cellular function.1The homeostatic response to metabolic acidosis involves first buffering of the acid, then increasing respiratory rate to lower the partial pressure of carbon dioxide (Pco2), and finally renal excretion of the additional acid. The initial step, buffering of the additional acid, is critical to the immediate restoration toward neutral pH allowing the preservation of life. The final step, renal excretion of the acid, begins hours after the acid challenge and is complete only days later. Renal acid excretion relies upon normal kidney function; as we age, our ability to excrete acid declines and humans become slightly, but significantly, more acidemic.3