PMID: 3320262Aug 1, 1987Paper

Renal and hepatic nitrogen metabolism in systemic acid base regulation

Journal of Clinical Chemistry and Clinical Biochemistry. Zeitschrift Für Klinische Chemie Und Klinische Biochemie
W G GuderW Gerok

Abstract

Renal and hepatic nitrogen metabolism are linked by an interorgan glutamine flux, coupling both renal ammoniagenesis and hepatic urea production to systemic acid-base regulation. Reconsideration of established pathways and recent observations led to a conceptional change with a movement from a two-organ concept (lungs and kidney) of acid-base balance to a three-or-more organ concept (lungs, kidney, liver). This development implies new regulatory sites of systemic pH control and consequently a new pathophysiological understanding of derangements of acid-base homeostasis. In this new concept the urea cycle regulates the removal of metabolically generated bicarbonate during a protein load in a pH- and bicarbonate-dependent manner. This is related to a switch of hepatic ammonium detoxication from urea to glutamine synthesis in metabolic acidosis, and vice versa in alkalosis. An adaptive increase in the renal capacity for glutamine deamidation and deamination and for ammonium excretion leads to a proportional decrease in renal urea excretion at the expense of ammonium in acidotic conditions. The present review summarizes experimental data and clinical implications resulting from this new concept, which was also the subject of a rece...Continue Reading

References

Sep 15, 1986·Klinische Wochenschrift·S Silbernagl, D Scheller
Apr 1, 1986·Biological Chemistry Hoppe-Seyler·T C Welbourne
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Mar 19, 1970·The New England Journal of Medicine·G F Cahill
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Citations

Sep 4, 2009·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·B Dawson-HughesG E Dallal
May 23, 2001·Nutrition·F BozzettiG Facchetti
Dec 9, 2000·Annual Review of Entomology·J F Harrison
Feb 23, 1999·Kidney International·M StumvollJ Gerich
Jun 1, 1995·Kidney International·N CanoX M Leverve
Apr 1, 1995·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·N CanoJ P Reynier
Jun 8, 2017·Nutrients·Renata Alves CarnaubaGilberti Helena Hübscher

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