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The kidneys play a crucial role in maintaining the body's acid-base balance, ensuring that the pH of blood remains within the narrow range of 7.35 to 7.45. This balance is essential for the proper functioning of enzymes, metabolic processes, and cellular functions. The kidneys regulate blood pH by managing the excretion of hydrogen ions (H⁺), reabsorption of bicarbonate ions (HCO₃⁻), and production of new bicarbonate. These mechanisms operate in concert with buffer systems and respiratory compensation to maintain homeostasis. The human body produces a significant amount of acids daily from metabolic processes. Volatile acids like carbonic acid result from the metabolism of carbohydrates and fats, while non-volatile acids such as sulfuric acid and phosphoric acid are derived from protein metabolism. The lungs help eliminate volatile acid via carbon dioxide (CO₂), while the kidneys handle non-volatile acid excretion. This function becomes especially critical because the kidneys are the only organ system capable of excreting excess non-volatile acids and regenerating bicarbonate. One of the primary mechanisms the kidneys use to regulate pH is the reabsorption of filtered bicarbonate. Bicarbonate is freely filtered at the glomerulus. If all of it were excreted, the body would become acidotic. Therefore, about 80–90% of the filtered bicarbonate is reabsorbed in the proximal convoluted tubule (PCT), with the ______ __________ _____ ______ ________ _______.
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