Our present conception of the physiologic acid-base equilibrium, resting largely on the work of L. J. Henderson,1 assigns to the kidney the principal rôle in maintaining the normal alkalinity of the body fluids. So adequate is the healthy kidney in this respect that the production of acid within the body may be increased to many times the basal amount, as, for example, during great muscular exertion and in the ketosis of diabetes mellitus, without sensibly reducing the bicarbonate content of the blood.
Indeed, from the work of Straub and Schlayer,2 Lewis and his co-workers,3 of Peabody,4 Whitney,5 MacNider,6 Gettler and St. George,7 Chace and Myers,8 and others, it appears that no appreciable reduction of the blood bicarbonate occurs, until the function of the kidney, as determined by the conventional tests, has been affected gravely. Acidosis, defined as a condition of lowered blood bicarbonate, appears, then, to be of little importance
RIEGER JB, FREUND HA. THE ALKALIMETRY OF WHOLE BLOODSECOND PAPER: THE ACID FIXING POWER OF THE BLOOD IN RENAL DISEASE. Arch Intern Med (Chic). 1922;30(4):517–530. doi:10.1001/archinte.1922.00110100111008
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