Fluid-Electrolyte and Acid Base

Balance

Biochemistry Department
Fluid, Electrolyte, and Acid-Base Balance
Explain what is meant by
fluid balance, electrolyte
balance, and acid-base
balance

Describe the
compensatory mechanisms Compare the compositions
involved in acid-base of ICF and ECF
balance

Identify the hormones

Explain the buffering that play important
systems that balance the roles in regulating fluid
pH of the ICF and ECF and electrolyte
balance

Describe the movement of fluid that

Discuss how Na+, K+, Ca2+and Cl- ions
takes place within the ECF, between
are regulated to maintain electrolyte
the ECF and the ICF, and between the
balance
ECF and the environment
 What is an Electrolyte?

An electrolyte is a substance, that when dissolved in water,

gives a solution that can conduct electricity
(Electrochemistry Dictionary)

Simple inorganic salts

Electrolytes dissociate when dissolved in water to form

positively and negatively charged ions
(Dissociation and electrolytes)

All inorganic acids, bases, salts, are electrolytes

Also known as Ionic solutes

 SECTION 27-1: Maintenance of
normal fluid volume and composition
is vital

Extracellular Intracellular Acid-base

fluid (ECF) fluid (ICF) balance
Fluid balance =
Interstitial fluid, The cytosol Electrolyte H+ gain is offset
plasma, and other The amount of by their loss
balance = The
body fluids water gained
ion gain each
each day
day equals the
equals the
ion loss
amount lost
 SECTION 27-2: An Introduction to
Fluid and Electrolyte Balance

The ECF and the ICF are two distinct fluid

compartment

ICF

The cytosol of cells

Makes up about two-thirds of the total body water

ECF

Major components include the interstitial fluid and plasma

Minor components include all other extracellular fluids
Figure 27.1 The Composition of the Human Body
 Regulation of fluids and electrolytes

Homeostatic mechanisms No receptors directly

respond to changes in ECF monitor fluid or
electrolyte balance

Respond to changes in
plasma volume or
osmotic concentrations
All water moves
passively in response to
osmotic gradients
Body content of water
or electrolytes rises if
intake exceeds outflow
Figure 27.2 Cations and Anions in Body Fluids
 Primary regulatory
hormones

Antidiuretic Natriuretic
hormone Aldosterone peptides (ANP
(ADH) and BNP)

Stimulates Controls Na+ Reduce thirst

water absorption and and block the
conservation and K+ loss along the release of ADH
the thirst center DCT and aldosterone
 Interplay between fluid
balance and electrolyte
balance

Different mechanisms regulate fluid and

electrolyte balance
This distinction is vital in the clinical setting
 SECTION 27-3: Fluid
Balance

Water losses are

Fluid moves freely within
normally balanced by
ECF compartment
gains
Eating
Drinking
Metabolic generation
Movements
Figure 27.3 Fluid Exchanges
 Fluid exchange with the environment

The major routes of

fluid exchange with the
environment include:

Temperature
Water loss rise from fever Water gains
 Water excess and depletion

Hypernatremi
Hyponatremia Dehydration
a

Na+ concentration Develops when

in the ECF is Na+ in the ECF is water loss
reduced abnormally high outpaces water
(overhydration) gains
 Fluid shifts

Water movement between ECF and ICF

If ECF becomes hypertonic relative to ICF,

water moves from ICF to ECF
If ECF becomes hypotonic relative to ICF,
water moves from ECF into cells
 SECTION 27-4: Electrolyte Balance

Problems with Electrolyte Balance

Potassium
Usually result from
imbalances are less
sodium ion
common, but more
imbalances
dangerous
 Sodium balance
Rate of sodium uptake Shifts in sodium
across digestive tract balance result in
directly proportional expansion or
to dietary intake contraction of ECF

Large variations
corrected by homeostatic
Sodium losses occur
mechanisms
through urine and
Too low, ADH / aldosterone
perspiration secreted
Too high, ANP secreted
 Figure 27.4 The Homeostatic Regulation of
Normal Sodium Ion Concentrations in Body Fluids
Figure 27.5 The Integration of Fluid
Volume Regulation and Sodium Ion
Concentrations in Body Fluids

Figure 27.5
Potassium balance
Not as closely regulated as sodium
Potassium ion excretion increases as
ECF concentrations rise
Aldosterone secreted
pH rises
Potassium retention occurs when pH
falls
Potassium ion
concentrations in ECF
are low
 ECF Concentrations of other
electrolytes

Magnesium Chloride
Bone reserves, balance Absorbed by the balance
absorption in Absorbed by the PCT in response Absorbed at
the digestive to calcitriol
PCT to keep digestive tract
tract, and loss
pace with to balance
at kidneys
urinary losses losses in urine
Calcium Phosphate and sweat
balance balance
 SECTION 27-5: Acid-base
Balance

The pH of the ECF remains between 7.35 and 7.45

If plasma levels fall below 7.35 (acidemia), acidosis

results
If plasma levels rise above 7.45 (alkalemia), alkalosis
results
Alteration outside these boundaries affects all body
systems
Can result in coma, cardiac failure, and circulatory
collapse
 Types of acids in the body

Volatile acid Fixed acids Organic acids

Can leave Acids that do Participants

solution and not leave in or by-
enter the solution products of
atmosphere (e.g. sulfuric aerobic
(e.g. and metabolism
carbonic phosphoric
acid) acids)
 Common Acids
Carbonic acid is
most important Sulfuric acid and
Organic acids
factor affecting pH phosphoric acid
of ECF

CO2 reacts with Metabolic

Generated during
byproducts such as
water to form catabolism of
lactic acid, ketone
carbonic acid amino acids
bodies

Inverse
relationship
between pH and
concentration of
CO2
Figure 27.6 The Basic Relationship
between PCO2 and Plasma pH
Mechanisms of pH control

Three major buffering

systems:
Protein buffer system
Amino acid
Buffer system consists of a H+ are buffered by hemoglobin
weak acid and its anion buffer system
Carbonic acid-bicarbonate
Buffer changes caused by
organic and fixed acids
Phosphate
Buffer pH in the ICF
 Protein buffer system

If pH climbs, If the pH drops, Hemoglobin

the carboxyl the amino buffer system
group of amino group acts as a Prevents pH
acid acts as a weak base changes when PCO2
weak acid is rising or falling
Figure 27.8 Amino Acid
Buffers
Carbonic Acid-Bicarbonate Buffering System

Carbonic acid- Has the

bicarbonate following
buffer system limitations:

Cannot protect the

CO2 + H2O H2CO3 ECF from pH changes
H+ + CO3 due to increased or
depressed CO2 levels

Only functions when

respiratory system
and control centers
are working normally

It is limited by
availability of
bicarbonate ions
(bicarbonate reserve)
Figure 27.9 The Carbonic Acid-
Bicarbonate Buffer System
 Maintenance of acid-base balance

Lungs help regulate

Kidneys help
pH through carbonic
regulate pH through
acid - bicarbonate
renal compensation
buffer system

Changing
respiratory rates
changes PCO2
Respiratory
compensation
Figure 27.10 Kidney tubules and pH
Regulation
 Figure 27.10 Kidney
tubules and pH Regulation
SECTION 27-6: Disturbances of Acid-base Balance

Maintain
tight
control
within
Buffer range 7.35
Renal
Respiration 7.45
systems function
 Figure 27.11 The Central Role of the
Carbonic Acid-Bicarbonate Buffer
System in the Regulation of Plasma pH
 Figure 27.11 The Central Role of the
Carbonic Acid-Bicarbonate Buffer
System in the Regulation of Plasma pH
 Acid-Base
Disorders
Respiratory Metabolic
acid-base acid-base
disorders disorders
Result when
abnormal
respiratory Generation of
function causes organic or fixed
rise or fall in CO2 acids
in ECF

Anything affecting
concentration of
bicarbonate ions in
ECF
 Respiratory acid-base
disorders

Respirator Respirator
y acidosis y alkalosis
Results from
excessive levels Relatively rare
of CO2 in body condition
fluids

Associated with
hyperventilatio
n
Figure 27.12 Respiratory Acid-
Base Regulation
Figure 27.12 Respiratory Acid-Base
Regulation
 Metabolic acid-base
disorders
Major causes of
Metabolic
metabolic
alkalosis
acidosis are:

Production of Occurs when

Depletion of Inability to Bicarbonate loss HCO3-
large numbers of
bicarbonate excrete hydrogen due to chronic
fixed / organic concentrations
reserve ions at kidneys diarrhea
acids become elevated

Caused by
repeated
vomiting
Figure 27.13 The Response
to Metabolic Acidosis
Figure 27.14
Metabolic
Alkalosis

Figure 27.14
Detection of acidosis and
alkalosis

Distinguish
Diagnostic between
blood tests respiratory and
metabolic

PCO2 Bicarbonate
Blood pH
levels
Figure 27.15 A Diagnostic Chart
for Acid-Base Disorders
 SECTION 27-7: Aging and Fluid,
Electrolyte, and Acid-base Balance

Increased water
Impaired ability to demands
Reduced total body
perform renal Reduced ability to
water content concentrate urine
compensation
Reduced sensitivity to
ADH/ aldosterone

Secondary conditions
Inability to perform
that affect fluid,
Net loss of minerals respiratory
electrolyte, acid-base
compensation
balance
 You should now be familiar with:

What is meant by fluid balance, electrolyte balance, and acid-

base balance

The compositions of intracellular and extracellular fluids

The hormones that play important roles in regulating fluid and

electrolyte balance

The movement of fluid that takes place within the ECF, between the
ECF and the ICF, and between the ECF and the environment
You should now be familiar with:

How sodium, potassium, calcium

and chloride ions are regulated to
maintain electrolyte balance

The buffering systems that balance the pH

of the intracellular and extracellular fluids

The compensatory mechanisms involved in acid-

base balance