Sulfate and acid-base balance

Autor: Troels Ring, Sebastian Frische, Stephen Edward Rees, Jette Nybo, Søren Risom Kristensen
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Ring, T, Frische, S, Rees, S E, Nybo, J & Kristensen, S R 2023, ' Sulfate and acid-base balance ', Scandinavian Journal of Clinical and Laboratory Investigation, vol. 83, no. 3, pp. 166-172 . https://doi.org/10.1080/00365513.2023.2188607
DOI: 10.1080/00365513.2023.2188607
Popis: It has been acknowledged for years that compounds containing sulfur (S) are an important source of endogenous acid production. In the metabolism, S is oxidized to sulfate, and therefore the mEq sulfate excreted in the urine is counted as acid retained in the body. In this study we show that pH in fluids with constant [Na] and [HEPES] declines as sulfate ions are added, and we show that titratable acidity increases exactly with the equivalents of sulfate. Therefore, sulfate excretion in urine is also acid excretion per se. This is in accordance with the down-regulation of proximal sulfate reabsorption under acidosis and the observation that children with distal renal tubular acidosis may be sulfate depleted. These results are well explained using charge-balance modeling, which is based only on the three fundamental principles of electroneutrality, conservation of mass, and rules of dissociation as devised from physical chemistry. In contrast, the findings are in contrast to expectations from conventional narratives. These are unable to understand the decreasing pH as sulfate is added since no conventional acid is present. The results may undermine the traditional notion of endogenous acid production since in the case of sulfur balance, S oxidation and its excretion as sulfate exactly balance each other. Possible clinical correlates with these findings are discussed.
Databáze: OpenAIRE