Regulation of Body Fluids, Electrolytes and Acid-Base Balance

by: Mohamad Taufik Hidayat b. Baharuldin Unit of Physiology, Department of Human Anatomy, FPSK, UPM

Key Concepts:
1) Water is the most abundant constituent of body fluids. 2) Water moves from one body to compartment to another in response to pressure changes. 3) The bodys acid-base balance is maintained by buffer systems, respiratory regulation, and renal regulation. 4) Chemicals called electrolytes are crucial to the regulation of fluid balance.

Body fluids: Compartments and Composition

- All body fluids either ICF or ECF - ICF include water & electrolytes enclosed by cell membranes , 63% of total body water - ECF include ISF, blood plasma & transcellular fluid, 37% of total body water - Transcellular fluid: cerebrospinal fluid, synovial fluid, aqueous & vitreous humor, serous fluid, peritoneal fluid

Movement of fluids between compartment

- Movements of water from one compartment to another is controlled by 1) hydrostatic pressure 2) osmotic pressure

Water
- 47 60% of total body weight, depending on sex, body fat & age - Adult female less water/unit weight, bcoz have more adipose tissue than males

- % of water decrease with age. A newborn 77% of TB weight is water

Functions of water
1) Acts in the transport of nutrients to cells and in carrying waste products from cells. 2) It provide a liquid medium for intracellular chemical reactions 3) Acts as a solvent for electrolytes & other solutes 4) Helps maintain body temperature, aids digestion & promotes excretion

Intake of water
- Under normal conditions, water is taken into and excreted from the body in equal amounts - 60% intake thru ingested fluids drinking water - 30% intake thru ingested foods preformed water - 10% by metabolic water byproduct of the oxidation of food in cells

Output of water
- Under normal conditions, the kidneys are the primary organs responsible for excreting water 60%

- Skin (sweat)-6%, GIT (feces)-6%, lungs (water vapor)-28%

- extreme conditions, the percentages vary, strenuous exercise loss of water thru skin, severe diarrhea/vomiting increase loss of water & solutes

Water intake is regulated by

Water output is regulated by

Electrolytes : Function & Regulation

- Electrolytes are compounds that dissociate into ions when in solution making it possible for the solution to conduct an electrical current

- Positive ions are called cations, and negative ions are anions

- Acids, bases and salts are electrolytes

- Most physiologically important electrolytes : sodium, potassium, calcium, magnesium, hydrogen, bicarbonate, chloride, phosphate & sulfate

Electrolytes have four major functions in the body: a) Facilitates normal cell metabolism b) Facilitate osmotic movement of water c) Help maintain acid-base balance d) Production and maintenance of RMP & AP

Sodium
- Sodium content of an adult is 142 mEq/L in ECF, ICF = 5 mEq/L - Sodium is a very important ion in osmotic regulation - Low plasma sodium concentration is called hyponatremia and high is hypernatremia

- Sodium level in the plasma is maintained by 3 hormones:

a) Aldosterone b) ADH (antidiuretic hormone) c) ANP (atrial natriuretic peptide)

a) Aldosterone

b) ADH
Decrease in sodium concentration (hypo-osmol)

Decrease the release of ADH

Increase water loss in the urine

Return the sodium concentration to normal (iso-osmol)

c) Atrial natriuretic peptide hormone

ANP is a vasodilator afferent arteriole Inhibit renin Na+ secretion, water follow

GFR

Blood volume

Blood pressure

Potassium
- Potassium content of an adult is 4.5 mEq/L in ECF, ICF = 140 mEq/L

- Extremely important in generating & maintaining resting membrane potential and also in repolarizing action potentials
- Most lost due to excretion in urine, some in sweat & feces

Chloride
- Normal plasma concentration is 103 mEq/L, high concentration in ECF

- Play major role in maintaining water balance (by maintain osmotic pressure)
- Its movement follow sodium or potassium (electrical charged) - When sodium is reabsorbed actively, chloride follows passively - When potassium is secreted, chloride accompanies it

Calcium
- Normal concentration in ECF is 4.5-5.5 mEq/L - Major roles in structural & component of bones and teeth, blood clotting, muscle contraction, nerve-impulse transmission - Plasma level is under control of PTH & CT (parathyroid hormone & calcitonin)

Phosphate
- Normal concentration in ECF is 1.7-2.6 mEq/L

- Plasma level is also under the control of PTH & CT (parathyroid hormone & calcitonin)
- Found in bones & teeth in form of calcium phosphate salts

Acid-Base Balance
- When one refer to the regulation of the acid-base balance in the body, its meant the regulation of hydrogen ions in body fluids - Enzymes and hormones activities can all be affected by the concentration of hydrogen ions - The pH of blood is maintained b/ween 7.35-7.45 - Maintaining an acceptable pH range is accomplished by: a) Chemical buffer systems (very rapid react, less than a second) b) Respiratory regulation (rapid react, second to minutes) c) Renal regulation (slow react, minutes to hours)

Chemical buffer systems

Bicarbonate buffer system

Protein buffer system

Phosphate buffer system

Bicarbonate buffer system

H2CO3 H+ + HCO3NaHCO3 Na+ + HCO3-

- If hydrogen ions generated is , they react with bicarbonate ion H+ + HCO3- H2CO3 CO2 + H2O (concentration of H+ remain unchanged) - If hydrogen ions are lost , more carbonic acid dissociates H2CO3 H+ + HCO3- (concentration of H+ remain unchanged) - If a strong acid/base is added such as HCl or NaOH???? HCl + NaHCO3 NaCl + H2CO3 ;

NaOH + H2CO3 NaHCO3 + H2O

Phosphate buffer system

NaH2PO4 weak acid Na2HPO4
weak base

- If a strong acid/base is added such as HCl or NaOH????

HCl + Na2HPO4 NaCl + NaH2PO4 ;

NaOH + NaH2PO4 Na2HPO4 + H2O

Protein buffer system

- Proteins are polymers of amino acid - Some amino acid have carboxyl groups which dissociate to release H+ R*-COOH RCOO- + H+ + OH- Other amino acid such as NH2 act as base

H 2O

R-NH2 + H+ R-NH3+

Respiratory regulation of acid-base balance

Renal Regulation of pH

a) ph regulation by hydrogen-ion secretion

b) ph regulation by ammonia

c) ph regulation by phosphate buffer

Abnormalities of Acid-Base Balance

- Acidosis ; drop of arterial blood pH below 7.35 : acidemia

- Alkalosis ; pH of arterial blood above 7.45 : alkalemia

- Acidosis & Alkalosis can be classified according to its causes either respiratory or metabolic
pH Respiratory acidosis H+ PCO2 HCO3-

Respiratory alkalosis
Metabolic acidosis Metabolic alkalosis

Respiratory and Renal Compensations

- When acid-base imbalance occur due to inadequate functioning of one buffer system (the lungs or kidneys) the other system tries to compensate - The respiratory system attempt to compensate metabolic acid-base imbalances,..and the kidneys work to correct imbalances coz by respiratory disease
pH Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis H+ PCO2 HCO3-