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Previous Volume 339:819-826 September 17, 1998 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Under normal physiologic conditions, acid–base balance is maintained by renal excretion of hydrogen ions generated during the metabolism of dietary protein and other metabolic processes. In normal subjects, these so-called fixed acids are produced at an average rate of approximately 1 mmol per kilogram of body weight, or 50 to 70 mmol per day, with a variety of organic acids accounting for half this amount and sulfuric and phosphoric acids for the remainder. When a disturbance in systemic pH occurs as the result of an excess or loss of acid or base, shifts in body buffers and ventilatory adjustment of . . . [Full Text of this Article]

Influence of pH on Keto Acid Metabolism

Influence of pH on Lactic Acid Metabolism

Other Endogenous Acids

Clinical and Pathophysiologic Implications

Effect on Energy Metabolism

            Prolonged Fasting

            Exercise

Acute and Chronic Acid–Base Disturbances and Increased Organic Acid Production

            Pregnancy

            Alcohol-Associated Ketoacidosis

            Salicylate Intoxication

Treatment of Ketoacidosis and Lactic Acidosis

            Diabetic Ketoacidosis

            Fasting and Hypocaloric Ketogenic Diets

            Lactic Acidosis

Reduced Renal Acid Excretion

            Renal Tubular Acidosis

            End-Stage Renal Disease

Conclusions

Source Information

From the University of Vermont College of Medicine, Burlington (V.L.H.), and the University of Pennsylvania School of Medicine, Philadelphia (R.L.T.).

Address reprint requests to Dr. Hood at the University of Vermont College of Medicine, 317 Burgess Bldg., Fletcher Allen Health Care, Burlington, VT 05401.

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