Buffer Medicine
What is the buffer?
To understand the concept of buffer in chemistry, it is better to remind you of the meaning of pH.
pH could be defined mathematically as a minus log of Hydrogen ion (proton) concentration in molarity expression (-log[H+]). Therefore, it is widely concluded a higher concentration of protons leads to an acidic solution, while less protons concentration leads to a basic (alkaline) solution.
Practically, if the pH is 7, it means a neutral solution; a pH less than 7 is acidic, while more than 7 will be alkaline.
Thus, a Buffer solution could be defined as a solution that prevents a significant variation in pH unless the variations exceed the solution's buffering capacity.
Buffer System in the body
Extracellular
Bicarbonate that might responsible for 80% of extracellular buffering
Carbonic Acid buffer system
Plasma Proteins
Ammonia
Intracellular
Phosphate
Proteins
Heamoglobin
Failure of Buffer
Failure of buffer results either in elevation of pH (acidic pH) or a decrease in pH (alkaline pH). The usual physiological pH in the body is 7.35 to 7.45, if it is less than that called acidosis (acidemia), more than the range called alkalosis (alkalemia). pH imbalances in the body can lead to various diseases and health complications.
Acidosis-Related Diseases
Acidosis occurs when the blood pH falls below 7.35. Metabolic or respiratory factors can cause it. Metabolic acidosis is often associated with conditions such as diabetic ketoacidosis, kidney failure, and severe dehydration. Respiratory acidosis, on the other hand, is typically linked to lung diseases like chronic obstructive pulmonary disease (COPD), pneumonia, and severe asthma attacks.
Alkalosis-Related Diseases
Alkalosis is characterized by a blood pH above 7.45. Metabolic alkalosis can result from excessive vomiting, overuse of antacids, or certain endocrine disorders like Cushing's syndrome. Respiratory alkalosis is often caused by hyperventilation, which may be triggered by anxiety, high fever, or exposure to high altitudes.
Impact on Health
Both acidosis and alkalosis can have serious health consequences. Symptoms of pH imbalance may include confusion, fatigue, headaches, and, in severe cases, seizures or coma. Chronic pH imbalances can also affect various organ systems, particularly the kidneys, bones, and muscles.
Kidney Disease and pH Balance
Kidney disease is closely linked to pH imbalances, particularly metabolic acidosis. As kidney function declines, the body's ability to regulate acid-base balance is compromised, leading to acid buildup in the blood. This can further damage the kidneys, creating a vicious cycle that may accelerate the progression of kidney disease.
Understanding these pH-related diseases is crucial for healthcare providers and patients alike. Proper diagnosis and management of underlying conditions causing pH imbalances are essential for maintaining overall health and preventing complications.
References:
Lancha Junior AH, Painelli Vde S, Saunders B, Artioli GG. Nutritional Strategies to Modulate Intracellular and Extracellular Buffering Capacity During High-Intensity Exercise. Sports Med. 2015 Nov;45 Suppl 1:S71-81. doi: 10.1007/s40279-015-0397-5.
Kelley MA, Kazemi H. Role of ammonia as a buffer in the central nervous system. Respir Physiol. 1974 Dec;22(3):345-59. doi: 10.1016/0034-5687(74)90083-8.
Hopkins E, Sanvictores T, Sharma S. Physiology, Acid Base Balance. 2022 Sep 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 29939584.