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 renal compensation  

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Author8 Posts

hello every one,

i just wanted to know within how many days kidney starts compensating for metabolic abnormalities originated from else where?


wouldn't it depend on the severity of metabolic derangement and the functional status of the kidney itself at that time? i don't think there is any standard time frame.

plz correct me if i'm wrong.


thanks for the reply.
please do not consider anything not given in the question stem. in this condition we assume kidneys are normal. to make it simple, lets say we have respiratory acidosis because of acute exacerbation of COPD. again please consider here that there were no metabolic abnormalities in this pt few hours back and kidneys were functioning normally .


i remember from physio video lectures that renal compensation takes time, i think probably 5-7 days to see the effect. but i m not very sure about it.


i'll have to read up on it too.

btw, thanks for this kick-start, i've been avoiding acid-base balance for so many days now! wink


In acute respiratory acidosis, compensation occurs in 2 steps. The initial response is cellular buffering that occurs over minutes to hours. Cellular buffering elevates plasma bicarbonate (HCO3-) only slightly, approximately 1 mEq/L for each 10-mm Hg increase in PaCO2. The second step is renal compensation that occurs over 3-5 days.

this is what i could find from eMedicine.

hope this helps


Renal compensation for sustained hypercapnia begins in 6-12 hours, but 3-5 days pass before maximal compensation occurs.

This is from a more recent eMed. article.


thanks a lot silvernod
all the best

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