Urological Health Chronic Kidney Disease Acid-Base Balance and Abnormalities By Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. Learn about our editorial process Deborah Leader, RN Medically reviewed by Medically reviewed by Jamin Brahmbhatt, MD on April 27, 2020 facebook linkedin Jamin Brahmbhatt, MD, is a board-certified urologist and Chief of Surgery at Orlando Health South Lake Hospital. Learn about our Medical Review Board Jamin Brahmbhatt, MD on April 27, 2020 Print Acid-base balance refers to a mechanism developed by the body to keep bodily fluids as close to a neutral pH as possible. In doing so, bodily fluids are kept from becoming too acidic (having too much acid) or too basic (having too much alkaline). A proper acid-base balance allows the body to function in a state of equilibrium, or stability. FatCamera / Getty Images What Is Normal Body pH? Body pH is measured on a scale from 1 to 14 with 1 being more acidic and 14 being more basic. Normal body pH is between 7.35 and 7.45. If body pH is less than 7.35, the body is "acidotic."If body pH is greater than 7.45, the body is "alkalotic" or "basic." When healthy, the body regulates the pH carefully through the kidneys (by removing or retaining acids and bases) or through the lungs (by breathing faster or slower.) Acids are produced by the normal metabolism of carbohydrates, proteins, and fats, for which the kidneys compensate by removing acid. Measurement The body pH is usually measured through a combination of tests that may include the pH of blood in the arteries, plus the level of electrolytes in plasma. Compensation If the pH of the body falls outside of the normal range, the body works to restore "homeostasis" or a state of equilibrium. It does this by: Renal compensation — The kidneys can buffer the pH by excreting acid or by retaining bicarbonate (a base.)Pulmonary compensation — If pH falls, in other words, if the body is acidotic, breathing may increase to blow off carbon dioxide to restore balance. Abnormalities Ordinarily, the pH of the body lies within this small range. If patients are unable to compensate for a change in pH, for example, due to serious illness, anemia, or malnutrition, a state of excess acid or base may occur. These can include the following: Metabolic Acidosis In metabolic acidosis there is an increased amount of body acid—in other words, the pH of the body falls below 7.35. Conditions which can cause this include: Diabetic ketoacidosisLactic acidosisSevere diarrheaKidney failureMedications such as aspirin Metabolic Alkalosis In metabolic alkalosis (when the pH increases), the amount of bicarbonate is increased, often due to the loss of metabolic acids. Conditions which can cause this may include: The use of diuretics (water pills)VomitingMedications such as steroidsCushing's syndrome Respiratory Acidosis In respiratory acidosis, the body retains excess carbon dioxide resulting in a more acidic body pH. Conditions which may cause this include: Hypoventilation — In other words, through shallow or infrequent breathingCOPD and other lung diseasesOverdoses of opioids and alcohol Respiratory Alkalosis In respiratory alkalosis, an excess level of carbon dioxide is blown off by the lungs. Conditions which may cause this include: Hyperventilation on a mechanical ventilatorLiver diseasePregnancySepticemia and other serious infectionsFeverAnxiety The acid-base balance system in a person with COPD is sometimes affected because of ineffective breathing patterns and the buildup of carbon dioxide. This can sometimes lead to respiratory failure, one of the complications of COPD. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Ayers P, Dixon C, Mays A. Acid-base disorders: learning the basics. Nutrition in Clinical Practice. 2015. 30(1):14-20. Gooch M. Identifying acid-base and electrolyte imbalances. Nurse Practitioner. 2015. 40(8):37-42.