Explain the principles underlying acid-base chemistry

Metabolic Acidosis

Compensation to metabolic acidosis includes:

  • Buffering
    Occurs over minutes to hours. Includes:
    • ECF buffers
      • Bicarbonate
      • Plasma proteins
        • Albumin
    • ICF buffers
      • Include phosphate, proteins
      • Leads to hyperkalaemia due to H+/K+ exchange
        K+ increases by 0.6mmol.L-1 per 0.1 unit fall in pH.
    • Bone
      Exchange of Na+ and Ca2+ in bone.
      • Leads to demineralisation and release of alkaline compounds
  • Respiratory compensation
    Occurs in minutes.
    • Rapid response
    • Cannot compensate completely
  • Renal compensation
    Occurs over days to weeks. Includes:
    • Elimination of H+ bound to filtered buffers
      • Include ammonium, phosphate
    • Reabsorption of bicarbonate
    • Active secretion of H+ in the DCT/CT
      Under control of aldosterone.


  1. Diaz, A. Describe how the body handles metabolic acidosis. Primary SAQs.
Last updated 2017-09-20

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