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Chapter Eleven, part 1: Regulation of Acid-Base Balance

Channel Your Enthusiasm

CHAPTER

Hydrogen Exchange in the Distal Nephron

Hydrogen gets secreted and the urinary pH drops when we talk about this minimal urine pH of 4.5. But what that means is there's a significant concentration gradient that you need to pump the hydrogen against. Burton Rose doesn't present the math, but he says that in order for you to use a hydrogen sodium exchanger like we have in the proximal tubule, if you needed that in the distal nephron, the intracellular sodium concentration would have to be less than one.

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