ABSTRACT
Cl acid load .....................................................................378 23.4 Renal tubule cell response to an NH
Cl acid load ........................................................380 23.5 Glutamine/Glutamate metabolism in acidotic cells.....................................................382 23.6 Cellular acidosis and glutamine metabolism contribute to programmed
cell death .............................................................................................................................384 Acknowledgments ......................................................................................................................385 References .....................................................................................................................................385
Amino acid metabolism in acidosis necessarily focuses upon glutamine, the predominant extracellular amino acid, and glutamate, the most significant intracellular amino acid. Metabolic acidosis, diagnosed as a reduction in plasma bicarbonate concentration, results from enhanced nonvolatile acid production derived from the incomplete oxidation of glucose yielding lactic acid and fatty acids yielding ketone bodies, and the complete oxidation of sulfur-containing amino acids and phospholipids yielding sulfuric acid and phosphoric acid, respectively. Thus a potential metabolic acidosis will be present in virtually all catabolic states,
