In the normal subject the reaction of the urine denotes the tendency to reaction change of the blood and organism—a tendency which is adjusted by the respiratory mechanisms. To maintain a constant blood pH and CO2/NaHCO3, the kidney retains or rejects base and the lungs increase or decrease acid (C02) output, these compensatory processes being interdependent. With a definite relationship between urinary acidity, blood alkali reserve and alveolar air CO2 tension the ratios are maintained. Urinary reaction represents the acid or alkaline “pressure”on the organism. The reaction of the blood and tissues depends on the adequacy of respiratory adjustment: in fact, as Henderson says, “low pH (acidity) in a fluid buffered like blood can never be due immediately to any other cause than relatively depressed breathing.”
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