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The Effects of Low CO2 on Kidney Function

Acidosis results when the body cannot maintain a correct oxygen/carbon dioxide (CO2) balance. Kidneys use CO2 in the bloodstream to make bicarbonate, which neutralizes acids in the blood. When CO2 levels are low, the result is renal tubular acidosis (RTA), a disruption of kidney function due to high blood acidity. According to the National Kidney and Urological Disease Information Clearinghouse, three types of acidosis affect the kidneys, each differentiated by the location of the disruption.

  1. Clinical Distal Renal Tubular Acidosis

    • The kidneys control pH levels in the blood through a process known as tubular secretion. Tubules are the exit path for urine to move from the kidneys to the bladder. When a problem occurs at the far end of the tubules, the resulting acidosis is known as clinical distal RTA. Symptoms include slowed growth in children, and severe kidney and bone deterioration in adults.

      Often doctors diagnose clinical distal RTA as a symptom of a systemic disease such as lupus, sickle cell anemia, hyperparathyroidism or chronic urinary tract infections. In addition, clinical distal RTA impairs the kidneys' ability to reabsorb potassium, resulting in extreme weakness and irregular heartbeat.

    Proximal Renal Tubular Acidosis

    • When the malfunction in the kidneys is located at the end of the tubule where the fluid and waste first enter, this is known as proximal RTA. Typically an inherited form of RTA, it is associated with diseases such as Fanconi's syndrome, caused by hereditary fructose intolerance and Wilson's disease, that disrupts the body's ability to break down nutrients,

    Hyperkalemic Renal Tubular Acidosis

    • Hyperkalemic RTA also occurs at the distal end of the tubule. However, it is different from classical distal RTA because the result is a high rather than low level of potassium in the bloodstream. Hyperkalemic RTA can result from the kidney's inability to regulate the flow of electrolytes, such as sodium and potassium, through the kidneys.

      Causes include genetics, cellular insensitivity to a regulatory hormone called aldosterone, or a side effect of certain medications.

    Treatment for Acidosis

    • In all three cases, treatment with sodium bicarbonate will help to return blood pH levels to normal, relieving the majority of the symptoms. With classical distal RTA and hyperkalemic RTA, additional measures need to be taken to restore correct potassium levels. Once blood pH and electrolyte levels have been restored to normal, the underlying cause of the acidosis will predict further treatment.

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