Important Questions to Ask About Renal Compensation

The human body can be compared to a clock mechanism. It has many pieces, some of them huge and complex and some others tiny and difficult to understand. However, no matter the size of each piece, all of them are important for the proper functioning of the clock. Humans have bodies that operate in a similar way. Joe Cosgrove knows that each internal organ plays a significant role in the correct functioning of the body and is in charge of a task that makes life possible and sustainable.

Among all the vital organs held by the human body, we can find the kidneys. These bean-shaped organs are not bigger than its owner’s fists. Nevertheless, they have some fundamental tasks that allow us to stay healthy and alive. Kidneys are responsible for cleaning waste from the blood and excreting it as urine. They also have a major function of maintaining pH in a narrow range so our system works properly. This process of maintaining the right pH balance is called Renal Compensation.


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How does renal compensation work?

First, let’s define the term “Renal Compensation” as a mechanism used by the kidneys to regulate the pH levels in the body. If the pH levels are not well compensated (out of a 7.35 to 7.4 range), the body fails to digest proteins, enzymes lose their capacity to properly function, and the body is basically unable to sustain itself.

For the kidneys, the compensation process takes more time than it would do for the lungs. This is why usually patients with pH imbalances are treated in the short term with ventilation therapies. However, the renal system has a powerful mechanism to control pH levels. This is how kidneys have the ability to excrete the excess acid or base in order to maintain the right pH levels.

Therefore, kidneys have two highly important roles in maintaining the acid–base balance in the body. They must reabsorb bicarbonate from urine through an Alkalosis process and they excrete hydrogen ions into urine thanks to an Acidosis process. In other words, renal compensation happens when kidneys need to control the total level of acidity, or pH, of blood serum.

Kidneys are built in a way they can determine if the blood is too acidic or alkaline. This way they decide which compound to excrete or retain, changing the absorption levels of bicarbonate and hydrogen. This process may take days until the kidneys are able to filter the blood and restore the right pH balance.


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What are Alkalosis and Acidosis?

We say Alkalosis happens when the pH levels are above 7.45. The alkalinity of the blood and other tissues happens and can be related to metabolic or respiratory disorders. Acidosis happens when blood pH becomes acidic thanks to the presence of too many hydrogen ions and too much carbon dioxide. Usually when people hyperventilate an increase in acidity of the blood and another body tissue occurs, forcing the kidneys to reabsorb more bicarbonate from the tubular fluid.

Kidneys are one of the body’s mechanisms to fight pH imbalances. Despite this, the process of balancing pH through the kidneys may take several days, making the process of renal compensation slower than respiratory compensation. It is always recommended to address the cause of the problem in order to help kidneys with the renal compensation process. Otherwise, if the cause keeps on affecting the pH levels of the blood, they won’t be able to maintain the desired acidic/basic values.

Related: The Role of the Kidneys in Acid-Base Balance

Why do pH levels change?

Just as a clockwork, if something fails in one organ it immediately will affect the rest of the body. This is how health issues with the metabolism and the respiratory tract will immediately affect the pH levels inside the body, forcing the kidneys to use the renal compensation mechanism. Changes in the way chemicals are exchanged and waste is produced and excreted affect the amount of nutrients and oxygen necessary for cells to properly work and develop. Breathing problems and metabolic disorders can lead to pH imbalances and when cells detect the presence of that imbalance they respond by releasing chemicals to stabilize the body that in most cases affect the blood serum pH and lead to renal compensation.

There are some cases where patients have another type of medical problems that can also lead to alkalosis or acidosis. To these patients, renal compensation may not be enough and the constant presence of chemicals in the blood can affect the kidneys as well, making it impossible pro them to compensate. In this circumstances, medical treatment needs to be addressed in order to eliminate the imbalance.

Blood tests can help physicians identify it renal compensation is occurring or if the prescribed treatment is allowing the body to respond. When numerous chemical can be seen in the blood, it means that the process of renal compensation is taking place. When this compensation fails and the kidneys stop responding, dialysis may be used as a measure to filter the blood. However, dialysis is never going to be as effective as having a pair of healthy kidneys.


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