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Equilibrio Ácido-Base

Equilibrio Ácido-Base

El pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance de la sangre está estrictamente regulado dentro del rango de 7,35–7,45 para garantizar funciones fisiológicas adecuadas. Cada día se generan grandes cantidades de ácido a través de procesos normales (respiración aeróbica/anaeróbica e ingesta dietética), y estos se manejan y eliminan de manera eficiente mediante amortiguadores en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre, el sistema respiratorio y el sistema renal. Cuando estos sistemas reguladores se alteran, se producen trastornos del equilibrio ácido-base, que incluyen acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis respiratoria, alcalosis respiratoria, acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis metabólica y alcalosis metabólica.

Last updated: Dec 15, 2025

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Contents

Descripción General de pH

El pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance es la medida cuantitativa de la acidez o basicidad de una solución.

  • pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance = –log10[H+]:
    • [H+] = concentración de iones de hidrógeno (i.e., protones) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum solución
    • Escala logarítmica de 1 a 14
      • 1 = máximamente ácido, 14 = máximamente básico
      • 7 = punto neutro: concentraciones iguales de H+ y OH–
  • El pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance normal de la sangre arterial es de aproximadamente 7,40.
  • El rango normal está estrictamente regulado para permanecer entre 7,35 y 7,45.
    • Acidemia Acidemia Respiratory Acidosis: más iones de hidrógeno (H+) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre = pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance < 7,35
    • Alcalemia: más iones de hidróxido (OH–) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre = pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance > 7,45
  • “-emia” frente a “-osis”
    • “-emia” significa “ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre”.
    • “-osis” se refiere a un proceso: La acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis y alcalosis se refieren a los LOS Neisseria procesos que causan acidemia Acidemia Respiratory Acidosis y alcalemia.
Relation between blood pH (x-axis) and concentration of hydrogen ions (y-axis)

Relación entre el pH de la sangre y la concentración de iones de hidrógeno.

Imagen por Lecturio.
Tabla: Ejemplos de valores de pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance de varios fluidos
Compartimiento pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance
Secreciones gástricas ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum condiciones de máxima acidez) 0,7
Lisosoma 5,5
Gránulos de cromafina 5,5
Neutro H2O a 37 ° C 6,81
Citosol de una célula típica 6,0–7,4
LCR 7,3
Plasma Plasma The residual portion of blood that is left after removal of blood cells by centrifugation without prior blood coagulation. Transfusion Products sanguíneo arterial 7,35–7,45
Matriz interna mitocondrial 7,5
Secreciones pancreáticas 8,1

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Ácidos, Bases y Amortiguadores

Las concentraciones relativas de ácidos y bases Bases Usually a hydroxide of lithium, sodium, potassium, rubidium or cesium, but also the carbonates of these metals, ammonia, and the amines. Acid-Base Balance en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre determinan su pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance. Los LOS Neisseria amortiguadores proporcionan una solución a corto plazo para las alteraciones de este equilibrio antes de que los LOS Neisseria pulmones y los LOS Neisseria riñones puedan actuar definitivamente para restablecer el equilibrio.

Ácidos

Los LOS Neisseria ácidos son compuestos que pueden donar protones (H+) o aceptar electrones.

  • Los LOS Neisseria H+ se liberan cuando los LOS Neisseria ácidos se disocian en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la solución → ↓ pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance
  • Clasificados por fuerza y volatilidad:
    • Ácidos fuertes:
      • Ionizar completamente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum agua
      • Más H+ liberado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el agua → mayor efecto sobre el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance
      • Ejemplo: ácido clorhídrico ( HCl HCL Hairy cell leukemia (HCL) is a rare, chronic, B-cell leukemia characterized by the accumulation of small mature B lymphocytes that have “hair-like projections” visible on microscopy. The abnormal cells accumulate in the peripheral blood, bone marrow (causing fibrosis), and red pulp of the spleen, leading to cytopenias. Hairy Cell Leukemia)
    • Ácidos débiles:
      • Ionizar parcialmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum agua
      • Menos H+ liberado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el agua → efecto relativamente menor sobre el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance
      • Ejemplo: ácido carbónico (H2CO3)
    • Ácidos volátiles:
      • Puede cambiar de fase a gas → extraíble a través de los LOS Neisseria pulmones
      • Ejemplo principal: CO2
      • El cuerpo produce aproximadamente 15 000 mmol de ácido volátil por día a través del metabolismo aeróbico.
    • Ácidos no volátiles (fijos):
      • No se puede cambiar de fase a gas → no se puede eliminar a través de los LOS Neisseria pulmones
      • Eliminado por los LOS Neisseria riñones
      • El cuerpo produce aproximadamente 70 mmol de ácidos fijos por día a través del metabolismo anaeróbico y el tracto gastrointestinal.
      • Ejemplos: ácido láctico, ácido úrico, ácido sulfúrico, ácido fosfórico

Bases Bases Usually a hydroxide of lithium, sodium, potassium, rubidium or cesium, but also the carbonates of these metals, ammonia, and the amines. Acid-Base Balance

Las bases Bases Usually a hydroxide of lithium, sodium, potassium, rubidium or cesium, but also the carbonates of these metals, ammonia, and the amines. Acid-Base Balance son compuestos que pueden aceptar protones (H+) o donar electrones.

  • Los LOS Neisseria iones hidróxido (OH–) se liberan cuando las bases Bases Usually a hydroxide of lithium, sodium, potassium, rubidium or cesium, but also the carbonates of these metals, ammonia, and the amines. Acid-Base Balance se disocian en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum solución:
    • Los LOS Neisseria OH– se combinan con H+ libre para formar H2O.
    • El resultado neto es menos [H+] → ↑ pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance (se vuelve más básico)
  • Clasificado por fuerza:
    • Bases Bases Usually a hydroxide of lithium, sodium, potassium, rubidium or cesium, but also the carbonates of these metals, ammonia, and the amines. Acid-Base Balance fuertes:
      • Ionizar completamente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum agua
      • Más OH– liberado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el agua → mayor efecto sobre el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance
      • Ejemplo: hidróxido de sodio (NaOH)
    • Bases Bases Usually a hydroxide of lithium, sodium, potassium, rubidium or cesium, but also the carbonates of these metals, ammonia, and the amines. Acid-Base Balance débiles:
      • Ionizar parcialmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum agua
      • Menos OH– liberado al AL Amyloidosis agua → relativamente menos efecto sobre el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance
      • Ejemplos: bicarbonato (HCO3–), amoníaco (NH3)

Amortiguadores

Los LOS Neisseria amortiguadores son sustancias que consumen o liberan iones de hidrógeno (H+) para estabilizar el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance.

  • La potencia amortiguadora se refiere a la cantidad de H + que se puede agregar o eliminar.
  • Categorizados como amortiguadores de bicarbonato y no bicarbonato:
    • Bicarbonato (HCO3–):
      • Tampón fisiológicamente más importante
      • HCO3– + H+ ⇆ H2CO3 ⇆ CO2 + H2O
    • Amortiguadores sin bicarbonato:
      • Menos importante fisiológicamente
      • Ejemplos: proteínas (e.g., albúmina, hemoglobina), fosfatos
  • pK: pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance de un tampón cuando está ionizado al AL Amyloidosis 50%
    • Ejemplo: bicarbonato
      • HCO3– + H+ ⇆ H2CO3
      • El 50% de HCO 3 y el 50% de H2CO3 se produce a pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance 6,1.
      • pK de bicarbonato = 6,1
    • Define el rango de pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance óptimo para la capacidad tampón de un tampón en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum particular
    • Los LOS Neisseria amortiguadores funcionan mejor cuando pK está cerca del pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance del fluido que están amortiguando.
  • Ecuación de Henderson-Hasselbalch:
    • Fórmula utilizada para determinar el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance de la sangre.
    • El pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance de la sangre depende principalmente de la proporción entre las cantidades de HCO3– (base) y CO2 (ácido) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre.
    • Ecuación: pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance = 6,1 + log ([HCO3–]/[0,03 × PCO2])
      • 6,1 = pK de HCO3– (tampón dominante en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre)
      • [HCO3–] = concentración de bicarbonato en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum sangre medida en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mEq/L
      • PCO2 = presión parcial de CO2 en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre medida en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum mmHg
      • 0,03 = factor de solubilidad para CO2
    • Se utiliza para generar curvas de titulación.
Tabla: Ejemplos de Henderson-Hasselbalch
Gasometría arterial normal Gasometría arterial ácida Gasometría arterial alcalótica
HCO 3– 24 mEq/L 26 mEq/L 22 mEq/L
PaCO 2 40 mm Hg 60 mm Hg 20 mm Hg
pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance 7,40 7,26 7,66

HCO3–: bicarbonato
PaCO2: presión parcial de CO2 en sangre arterial
Curva de valoración del bicarbonato en sangre

Curva de valoración del bicarbonato en sangre

Imagen por Lecturio.

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Manejo del Ácido en los Pulmones

El cuerpo produce aproximadamente 15 000 mmol de ácidos volátiles y 70 mmol de ácidos no volátiles al AL Amyloidosis día. Los LOS Neisseria pulmones y los LOS Neisseria riñones trabajan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum conjunto para eliminar esta carga ácida diaria, lo que evita que la capacidad amortiguadora de la sangre se sobrepase y le permite mantener un pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance normal.

  • La carga de ácido primaria producida por el cuerpo está en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de CO2 (un ácido volátil) producido a través del metabolismo aeróbico.
  • El CO2 se elimina a través del tracto respiratorio.
  • ↑ CO2 → ↑ respiración
Manejo de ácido en los pulmones.

Factores involucrados en el equilibrio ácido-base diario

Imagen por Lecturio.

Manejo del Ácido en los Riñones

Los LOS Neisseria riñones son los LOS Neisseria principales responsables de la eliminación de los LOS Neisseria ácidos fijos (no volátiles), aproximadamente 70 mmol al AL Amyloidosis día. Previenen la excreción de bicarbonato y también combinan la excreción de ácido con la nueva generación de bicarbonato para que el sistema tampón de bicarbonato esté siempre disponible a plena capacidad.

Reabsorción de bicarbonato

El bicarbonato se filtra libremente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el glomérulo y luego se reabsorbe el 100% (80% en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo proximal) a través del siguiente proceso:

  1. El intercambiador de iones de sodio–hidrógeno 3 ( NHE3 NHE3 A sodium-hydrogen antiporter expressed primarily by epithelial cells in the kidneys, it localizes to the apical membrane of the proximal kidney tubule, where it functions in sodium and water reabsorption and possibly calcium homeostasis. It also is expressed in heart, brain, and lung tissues and is resistant to amiloride inhibition. Carbonic Anhydrase Inhibitors) absorbe Na+ y secreta H+.
  2. El H+ secretado se combina con el HCO3– filtrado para formar H2CO3 en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el lumen tubular.
  3. El H2CO3 se convierte en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum H2O y CO2 mediante anhidrasa carbónica apical IV.
  4. El CO2 se difunde libremente a través de la membrana apical de regreso a la célula.
  5. La anhidrasa carbónica intracelular II convierte CO2 + H2O de nuevo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum H2CO3.
  6. Entonces, el H2CO3 puede disociarse en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum H+ y HCO3–:
    • Los LOS Neisseria H+ se reciclan a través del proceso a través de NHE3 NHE3 A sodium-hydrogen antiporter expressed primarily by epithelial cells in the kidneys, it localizes to the apical membrane of the proximal kidney tubule, where it functions in sodium and water reabsorption and possibly calcium homeostasis. It also is expressed in heart, brain, and lung tissues and is resistant to amiloride inhibition. Carbonic Anhydrase Inhibitors.
    • HCO3: se absorbe a través de la membrana basolateral a través de:
      • Cotransportador de Na+-HCO3–
      • Intercambiador de HCO3–-Cl–
  7. Efectos netos de todo el proceso:
    • Excreción de H+
    • Absorción de HCO3–
  8. Nota: El bicarbonato no es libremente permeable a través de la membrana apical porque es una molécula cargada.
  9. Ubicaciones de reabsorción de HCO3:
    • Túbulo proximal: 80%
    • Extremidad ascendente gruesa: 10%
    • Túbulo contorneado distal: 6%
    • Conducto colector: 4%
Reabsorción de bicarbonato en el túbulo proximal

Reabsorción de bicarbonato en el túbulo proximal

CA-IV: anhidrasa carbónica IV
CA-II: anhidrasa carbónica II

Imagen por Lecturio.
Renal reabsorption of HCO3

Reabsorción renal de HCO3–

Imagen por Lecturio.

Amoníaco (NH3)

El NH3 puede ayudar a excretar ácidos fijos.

  • Representa el 60% de la excreción de ácido fijo
  • Ocurre principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo proximal
  • El NH3 puede unirse al AL Amyloidosis H+, que luego se elimina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina:
    • Dentro del túbulo, el NH3 puede unirse a H+ → se convierte en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum NH4+, que permanece en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina y se excreta
    • El NH4+ puede generarse dentro de la célula del túbulo proximal y excretarse en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el líquido tubular.
  • El NH4+ (amonio) y el HCO3– se generan a partir del metabolismo de la glutamina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las mitocondrias:
    • Glutamina deshidrogenasa: glutamina → glutamato + NH4+, luego
    • Glutamato deshidrogenasa: glutamato → 𝛼 -cetoglutarato + NH4+, luego
    • El 𝛼-cetoglutarato entra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el ciclo de Krebs → genera 2 moléculas de HCO3–
  • El NH4+ se secreta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el líquido tubular a través de 2 mecanismos:
    • NHE3 NHE3 A sodium-hydrogen antiporter expressed primarily by epithelial cells in the kidneys, it localizes to the apical membrane of the proximal kidney tubule, where it functions in sodium and water reabsorption and possibly calcium homeostasis. It also is expressed in heart, brain, and lung tissues and is resistant to amiloride inhibition. Carbonic Anhydrase Inhibitors intercambia directamente Na+ por NH4+.
    • El NH3 es permeable a la membrana:
      • Cruza libremente desde el interior de la celda hacia el lumen tubular
      • Se combina con H+ libre para formar NH4+
  • El HCO3–, producido en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el ciclo de Krebs, se reabsorbe a través de la membrana basolateral hacia el torrente sanguíneo.
  • Este proceso es muy adaptable: se regula al AL Amyloidosis alza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis crónica.
Transporte de NH3 y NH4 + a la luz para su excreción

Transporte de NH3 y NH4+ a la luz para su excreción

Imagen por Lecturio.

Ácidos titulables

  • Representa el 40% de la excreción de ácido fijo
  • Ocurre en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el túbulo proximal, el túbulo contorneado distal y el conducto colector
  • Los LOS Neisseria ácidos titulables tamponan a H+ y luego se eliminan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina:
    • El H2CO3 intracelular se disocia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum H+ y HCO3–.
    • Los LOS Neisseria iones H+ se secretan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la luz tubular por:
      • H+-ATPasa tipo V
      • NHE3 NHE3 A sodium-hydrogen antiporter expressed primarily by epithelial cells in the kidneys, it localizes to the apical membrane of the proximal kidney tubule, where it functions in sodium and water reabsorption and possibly calcium homeostasis. It also is expressed in heart, brain, and lung tissues and is resistant to amiloride inhibition. Carbonic Anhydrase Inhibitors
    • El ácido titulable se une a H+.
    • El compuesto unido se excreta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina.
    • El HCO3– (del primer paso) queda dentro de la célula y se considera “regenerado”.
  • Ejemplos de ácidos titulables:
    • pK más cercano al AL Amyloidosis pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance de la orina normal → es más útil para unir H+ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum condiciones normales:
      • Fosfato (pK 6,8)
    • pK más lejos del pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance normal de la orina → es menos útil:
      • Urato (pK 5,8)
      • Creatinina (pK 5,0)
    • pK menor que el mínimo pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance posible en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum orina (aproximadamente 4,4) → no es útil:
      • Lactato (pK 3,9)
      • Piruvato (pK 2,5)
  • Este sistema no se regula al AL Amyloidosis alza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis crónica (a diferencia del sistema de amoníaco).
Example of phosphate as a titratable acid

Ejemplo de fosfato como ácido titulable:
Tenga en cuenta que los iones de H+ intracelulares se originan a partir de la disociación de H2CO3. Este es también el mecanismo para la regeneración de HCO3–.

Imagen por Lecturio.
Titration curves for phosphate and creatinine

Curvas de titulación para fosfato y creatinina:
El fosfato es un ácido mejor valorable debido a su mayor área bajo la curva dentro del rango del pH normal de la orina (4,5–8).

Imagen por Lecturio.

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Relevancia Clínica

Cuando un proceso patológico sobrepasa la capacidad normal de regular Regular Insulin el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance, se producen los LOS Neisseria trastornos ácido-base primarios que se enumeran a continuación. También se producen mecanismos compensatorios que ayudan a compensar el cambio de pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance.

  • Acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis metabólica: procesos que dan como resultado la acumulación de H+ y generalmente causan acidemia Acidemia Respiratory Acidosis (i.e., la disminución del pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance sanguíneo): este proceso puede ser el resultado de una pérdida excesiva de amortiguadores (e.g., diarrea) o una mayor producción de ácidos (e.g., cetoacidosis y acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis láctica).
  • Alcalosis metabólica: procesos que resultan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la acumulación de HCO3– y generalmente causan alcalemia (i.e, el aumento del pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance sanguíneo): este proceso puede ser el resultado de un suministro excesivo de amortiguadores o una mayor excreción de iones de hidrógeno. Las causas comunes son los LOS Neisseria vómitos y el síndrome de calcio y álcali.
  • Acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis respiratoria: procesos que resultan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la acumulación de CO2 arterial y generalmente causan acidemia Acidemia Respiratory Acidosis (i.e., la disminución del pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance sanguíneo): este proceso puede ser el resultado de una depuración deficiente de CO2 por los LOS Neisseria pulmones. Las causas comunes son la enfermedad pulmonar obstructiva crónica y el asma ASMA Autoimmune Hepatitis.
  • Alcalosis respiratoria: procesos que dan como resultado la disminución del CO2 arterial y generalmente causan alcalemia (i.e., el aumento del pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance sanguíneo): este proceso puede ser el resultado de una eliminación excesiva de CO2 de la sangre por una mayor ventilación. Las causas comunes incluyen embarazo, ansiedad y sobredosis de aspirina.

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Referencias

  1. Emmett, M., Palmer B.F. (2020). Simple and mixed acid–base disorders. UpToDate. Retrieved April 1, 2021, from https://www.uptodate.com/contents/simple-and-mixed-acid-base-disorders 
  2. Theodore, A. C. (2020). Arterial blood gases. UpToDate. Retrieved April 1, 2021, from https://www.uptodate.com/contents/arterial-blood-gases
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