Kidney plays an important role in maintenance of acid-base balance by excreting H+ ions and retaining

bicarbonate ions by Urine Acidification:

The two main functions in Urine Acidification includes:

1- H+ Secretion.
2- Bicarbonate ions Reabsorption.

Renal H+ Secretion:
Excretion of H+ occurs by three mechanisms:
1. Phosphate Mechanism.
2. Bicarbonate Mechanism.
3. Ammonia Mechanism. R

Renal H+ Secretion: (Phosphate Mechanism)

Step-1:
sodium-potassium pump on the baso-lateral membrane. low-sodium in the cell and high potassium in the
cytoplasm.

Step-2:
The concentration of sodium in the lumen of proximal convulated tubulue is high and the concentration of H+
ions is low in the tubular cell. Thus Na+ moves inside the cell, extruding H+ ions in the Tubular Fluid and this
phenomenon is known as Sodium-hydrogen counter transport

Step-3:
The concentration gradient of H+ ions in the cell being low indicates that the H+ ions are transported through
Primary active transport. This step is also called Secretion of H+ ions.

Carbonic Acid (Bicarbonate Mechanism)

Step-4:
The secreted H+ ions combines with Bicarbonate ions HCO3 that are already in the Tubular Fluid. H+ ions
and HCO3 together will allow to form Carbonic Acid- H2CO3.

Step-5: Carbonic Acid goes to the border of cell and dissociates into Carbondioxide and Water in the presence
of Carbonic Anhydrase Enzyme.

Step-6: Carbondioxide moves inside the cell and combines with the water molecules that are already present
inside. Carbondioxide and water molecules once again forms Carbonic Acid.

Step-7:
Carbonic Acid further breaks down into H+ ions and Bicarbonate ions.

Step-8:
Bicarbonate from the tubular cell enters the interstitium. Simultaneously, Na+ is reabsorbed from the renal
tubule under the influence of aldosterone.

Step-9: bicarbonate being re-absorbed by using Chloride transporter. Chloride ions moves inside the cell
while bicarbonate moves in the interstitial space. This step is also called Chloride-Bicarbonate Counter-
Transport.
Step-10:
Bicarbonate combines with Sodium to form Sodium Bicarbonate. Now the H+ is secreted into the tubular
lumen from the cell in exchange for Na+.

Renal H+ Secretion (Ammonia Mechanism)

Step-11:
Amonia in tubular cell is formed when the amino acid Glutamine is converted into Glutamic Acid in the
presence of the enzyme Glutaminase. Ammonia (NH3) formed in tubular cells is secreted into tubular lumen
in exchange for sodium ion.

Step-12: it combines with H+ to form Ammonium(NH4). Thus, H+ is added to urine in the form of
Ammonium Compounds resulting in acidification of urine. For each NH4 excreted one HCO3 is added to
interstitial fluid. Thus, by excreting H+ and conserving HCO3, kidneys produce acidic urine and help to
maintain the acid-base balance of body fluids