Metabolic production and renal disposal of hydrogen ions

Abstract

It is correct to state that ammonium ion excretion is not a significant pathway of actual hydrogen ion excretion; however, clinicians can still utilize this information to indicate the quantity of hydrogen ions eliminated by the kidney. The excretion of urine containing a greater proportion of H2PO4- to HPO4(=) than exists in the blood does result in actual hydrogen ion elimination in the urine. However, the clinician must recognize that part of the excess H2PO4- excreted was devied from dietary constituents and hence does not represent the excretional protons produced by other endogenous hydrogen ion producing pathways. In summary, net acid excretion rates as normally calculated do indicate, in quantitative terms, the renal contribution to acid elimination, but do not indicate the actual processes involved in the elimination of this acid.