Fluid, Electrolyte, and

Acid–Base Homeostasis
Rayvita Meagratia

r.meagratia@gmail.com
BODY FLUIDS
Total body water (TBW) content
Body fluid compartments
Body fluid compartments
• ICF
– Major cation : K+, Mg+
– Major anion : protein, organic
phosphates
Body fluid compartments

• ECF
– Major cation : Na+
– Major anion : Cl-, HCO3-
Body fluid compartments

• Plasma
– Major plasma protein:
albumin & globulin
Body fluid compartments

• Interstitial fluid
– has little protein
– ultrafiltrate of plasma
Water balance
 Maintain Fluid Balance In The Body

• Water added to the

body fluids always
enters & leaves the
body via the ECF
compartment first
• At steady state, ECF
osmolarity & ICF
osmolarity are equal
 water shifts
between ECF & ICF
Regulated Abnormal
Importance Regulation Mechanism
Variable Outcomes
ECF For long- ↓ ECF vol → ↓ BP Maintenance of salt
Volume term ↑ ECF vol → ↑ BP balance
control of (salt osmotically “holds”
arterial H2O, Na+ load determines
blood the ECF vol),
pressure accomplished primarily
by aldosterone-controlled
adjustments in urinary
Na+ excretion
ECF For ↓ ECF osm → cells Maintenance of free H2O
Osmolarity prevention swell balance,
of ↑ ECF osm → cells accomplished primarily
detrimental shrink by vasopressin-controlled
osmotic adjustments in
movement excretion of H2O in the
of H2O urine
• Osmosis = net diffusion of water across a
membrane
• Osmolarity = total solute concentration of a
solution
• One osmol is equal to 1 mol of solute
particles
• The osmolarity of the extracellular fluid is
normally about 300 mOsm
 Factors That Maintain Body Water Balance
FACTOR MECHANISM EFFECT
Thirst center in Stimulates desire to drink fluids Water gain if
hypothalamus thirst is quenched

Angiotensin II Stimulates secretion of aldosterone ↓loss of water in

urine
Aldosterone By promoting urinary reabsorption of Na & Cl, ↓loss of water in
increases water reabsorption via osmosis urine

Atrial Promotes natriuresis, elevated urinary ↑loss of water

natriuretic excretion of Na (and Cl), accompanied by in urine.
peptide (ANP) water
Antidiuretic Promotes insertion of water-channel ↓loss of water in
hormone (ADH) / proteins (aquaporin-2) into the apical urine
Vasopressin membranes of principal cells in the
collecting ducts of the kidneys  water
permeability ↑ more water is reabsorbed
 Stimulates
Water ↑ plasma osmoreceptors
deprivation osmolarity in anterior
hypothalamus

↑ water
↑ water permeability of ↑ secretion of
reabsorbstion late distal tubule ADH
& collecting duct

↑ urine
↓ plasma
osmolarity & ↓
osmolarity
urine volume
• Pathways
through which
dehydration
stimulates
thirst
• Pathways
through which
dehydration
stimulates
thirst
• Series of
events in
water
intoxication
ELECTROLYTES
Electrolyte and Protein Anion
Concentrations
 Sodium
• most abundant ions in extracellular fluid
• normal blood plasma Na+ concentration is 136–
148mEq/liter
• involved in impulse transmission, muscle
contraction, and fluid & electrolyte balance
• The kidneys excrete excess Na+, but also can
conserve it during periods of shortage
• Level in the blood is controlled by aldosterone,
ADH, and ANP
 Chloride
• most prevalent anions in extracellular fluid
• normal blood plasma Cl- concentration is 95–
105 mEq/liter
• part of the hydrochloric acid secreted into
gastric juice
• Cl- level is controlled indirectly by ADH and by
processes that increase or decrease renal
reabsorption of Na+
 Potassium
• most abundant cations in intracellular fluid
• normal blood plasma K+ concentration is 3.5–
5.0mEq/liter
• plays a key role in establishing the resting membrane
potential and in the repolarization phase of action
potentials in neurons and muscle fibers
• maintain normal intracellular fluid volume
• K+ moves into/out of cells, it often is exchanged for H+
helps regulate the pH of body fluids
• controlled mainly by aldosterone
 Bicarbonate
• second most abundant anions in extracellular
fluid
• the most important buffer in blood plasma
• kidneys are the main regulators of blood
HCO3- concentration
 Calcium
• most abundant mineral in the body
• Calcium salts are structural components of
bones and teeth
• function in blood clotting, neurotransmitter
release, maintenance of muscle tone, and
excitability of nervous and muscle tissue
• controlled mainly by parathyroid hormone
and calcitonin
 Phosphate
• intracellular anions
• their salts are structural components of bones
and teeth
• required for the synthesis of nucleic acids and
ATP and participate in buffer reactions
• controlled by parathyroid hormone and
calcitonin
 Magnesium
• primarily intracellular cations
• cofactor for certain enzymes needed for the
metabolism of carbohydrates and proteins,
and for the sodium–potassium pump
• Essential for normal neuromuscular activity,
synaptic transmission, and myocardial
functioning
• Secretion PTH depends on Mg2+
ACID–BASE BALANCE
• Overall acid–base balance of the body is
maintained by controlling the H concentration
of body fluids,especially extracellular fluid.
• The normal pH of systemic arterial blood is
7.35–7.45
Comparison of
pH values of
common
solutions
Comparison of
pH values of
common
solutions
Mechanisms That Maintain pH of Body
Fluids
• Buffers
– provide limited but immediate limitations on pH
change
• Changes in ventilation and CO2 excretion
– can occur over seconds to minutes to provide a
rapid second line of defense against pH change
• Renal system H+ excretion and HCO3− synthesis
– the final line of defense, acting over a period of
hours to days to prevent sustained pH change
 Buffer
• Any substance that can reversibly bind hydrogen ions
• Act quickly to temporarily bind H+, removing the
highly reactive, excess H+ from solution
• Raise pH of body fluids but do not remove H+ from
the body
• Include
– Proteins
• The most abundant buffers in body cells and blood
• Hemoglobin inside red blood cells is a good buffer
– Carbonic acid–bicarbonate
• Important regulator of blood pH
• The most abundant buffers in ECF
– Phosphates
• Important buffers in intracellular fluid and in urine
Changes in ventilation and CO2 excretion
• ↑exhalation of CO2 increases blood pH
(fewer H+)
– By increasing the rate and depth of breathing,
more CO2 can be exhaled  reduces the level of
carbonic acid in blood  raises the blood pH
• ↓exhalation of CO2 decreases blood pH (more
H+)
 Renal System
• Renal tubules secrete H+ into the urine and
reabsorb HCO3-
• In the proximal convoluted tubules of the
kidneys, Na/H antiporters secrete H+ as they
reabsorb Na+
• In the collecting ducts of the kidneys, some
intercalated cells reabsorb K+ and HCO3- and
secrete H+; other intercalated cells secrete
HCO3-
Renal System
 Sources of Hydrogen-Ion
Gain or Loss
Gain Loss

• Generation of H+ from CO2 • Utilization of H+in the

• Production of nonvolatile metabolism of various
acids from the metabolism organic anions
of protein and other • Loss of H+ in vomitus
organic molecules • Loss of H+ in the urine
• Gain of H+due to loss of • Hyperventilation
HCO3 in diarrhea or other
nongastric GI fluids
• Gain of H+due to loss of
HCO3 in the urine
 Acid-Base Disorders
• Respiratory disorders
– PaCO2 > 45 mm Hg  respiratory acidosis
– PaCO2 < 35 mm Hg  respiratory alkalosis
• Metabolic disorders
– HCO3– < 22 mEq/L  metabolic acidosis
– HCO3– > 28 mEq/L  metabolic alkalosis
CONCLUSION??