August 28th, 2017 - Brian Maguire

The urinary or renal system is in charge of producing, storing, and disposing of urine. This system consists of 2 kidneys, 2 ureters, the bladder, and the urethra. The kidneys form the urine by filtering the blood. Then the urine gets stored in the bladder after it passes through the ureters. Healthy people excrete 1-2 liters of urine a day, and healthy kidneys have a pH around 6.5.

When the blood’s pH becomes too acidic or too alkaline, the kidneys manipulate the blood’s pH to maintain a balanced state to keep you alive. The degree of this renal compensation depends on the length of time the acid-base disturbance has taken place. Interestingly enough, the kidneys can neutralize more acid or base than the respiratory system or any other buffering system since they can directly expel acid (H+) from the body. However, the kidneys can take days to release the acid whereas the lungs are more immediate. Other buffer systems can only reduce (H+) concentration by binding it to another chemical or mineral. So, in order to maintain acid-base balance, the urinary system uses the kidneys as buffers to eliminate excessive acids, dipping into the body’s precious bicarbonate and alkaline mineral reserves. 

The kidneys are a vast network of filters. Each individual filter is called a “nephron,” and each of your two kidneys has about one million nephrons that help to keep the blood clean. Seems like a never-ending supply, right? Not really. As the kidneys become worn out and damaged resulting from trauma, infections, undigested foods, consumption of unhealthy oxidized fats, processed foods, too much sugar and table salt, heavy metals (mercury, lead, cadmium, aluminum), pesticides, mold, candida, pharmaceutical drugs, other environmental and internally produced toxins, stress, atherosclerosis, uncontrolled diabetes, amyloidosis, and many other factors, the number of functioning nephrons diminishes. Dehydration from lack of fluids and or diuretic drugs CONCENTRATES and acidifies the urine stressing the kidneys further! Kidney function also declines with age, falling about 1% per year after age 40, especially when following a standard American diet and lifestyle. In reality, very few people have fully functioning kidneys.

As the acids build up and inflammation becomes chronic, the kidneys nephrons can die. Nephrons are the basic structural and functional unit of the kidneys used for filtering, reabsorption, and excretion. Unfortunately, nephrons cannot naturally regenerate in mammals once they die. When the number of functioning nephrons has declined by 70% to 80%, obvious health problems can begin to appear. You may feel fatigued, foggy, or short of breath when the kidneys can’t produce enough EPO hormone to stimulate red blood cell production in the bone marrow, resulting in anemia. Acidic waste can build up in the legs, ankles, feet, face, and/or hands when the kidneys can’t eliminate excess fluids. You may have to pee more often, it can become harder to urinate, and/or urine color is consistently darker. In some cases, you may even vomit as toxic waste backs up into the bloodstream.

As more kidney cells die, the risk for tubular damage and kidney failure greatly increases. Simultaneously, the heart needs to pump more blood to help out the kidneys, resulting in high blood pressure. You can see how ignorant it is to lower your blood pressure with diuretic drugs that can damage the kidneys, increasing blood pressure! The unresolved acidosis coupled with kidney issues magnifies the possibility of bone pathologies and nutritional deficiencies. In addition, overly acidic urine can generate toxic bacteria and fungi, creating an ideal environment for a urinary tract infection. Women are more prone to this type of infection because of their shorter urethra.

When functioning nephrons have declined 90% you either die or go on dialysis. “Kidney disease is often called a ‘silent’ disease, because most people have no symptoms before they are diagnosed. In fact, you might feel just fine until your kidneys have almost stopped working.” Guyton & Hall (pages 417-418)

In the presence of chronic acidity and inflammation, the body needs to switch gears in its attempt to maintain acid-base homeostasis. When the body becomes too acidic, resulting mostly from poor diet and lifestyle choices, vital minerals necessary to neutralize the acid are accessed from emergency stores in the body. When this is allowed to happen continually, toxic levels of uric, oxalic, and lactic acids can build up in the interstitial fluids and tissues. Simultaneously, minerals like calcium can be pulled from the skeleton (osteoporosis) forming kidney stones, and/or being re-deposited in the soft tissues, joints (arthritis), and arteries (arteriosclerosis). The excess accumulation of acids puts excessive additional stress on the kidneys and other detoxification organs. Bear in mind that the kidneys were only designed to handle normal byproducts of the metabolism, not excessive acid waste. The tubules (part of the nephrons) can become clogged much quicker than even the major arteries leading to chronic kidney disease (CKD).


When chronic kidney disease CKD develops, clinical pH imbalances can occur. Studies show that metabolic acidosis (increased levels of acidity, and the kidneys inability to form bicarbonate) is a common complication of CKD. Mounting evidence identifies acidosis not only as a result of, but as a CAUSE of kidney disease progression. (1)

In 2005, The American journal of kidney disease emphasized that metabolic acidosis is found in most patients with chronic kidney disease (CKD). CKD obstructs the filtration of waste products, and the level of acidosis correlates positively to the asperity of renal failure. (2)

Based on 2012 clinical trials, Kovesdy proposed that metabolic acidosis can be corrected or prevented by alkali therapy (the infusion of sodium bicarbonate – NaHCO3), decreasing kidney damage and slowing the progression of CKD. In the later stages alkali administration cannot always correct the acidosis, and dialysis must be initiated. (3)


Acid-base balance is required in order to maintain healthy kidneys and avoid renal disturbances. Keep in mind that while these references were associated with acidosis, alkalosis is also fairly common when the kidneys begin to fail. However, the origin of the kidney dysfunction almost always reverts back to previous acidic inflammatory conditions resulting from poor diet and lifestyle!



1-  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233646/

2- Kraut, J. A., & Kurtz, I. (2005). Metabolic acidosis of CKD: diagnosis, clinical characteristics, and treatment. American journal of kidney diseases, 45(6), 978-993.

3-Kovesdy, C. P. (2012). Metabolic acidosis and kidney disease: does bicarbonate therapy slow the progression of CKD?. Nephrology Dialysis Transplantation, 27(8), 3056-3062.

Sabatini, S. (1983). The acidosis of chronic renal failure. The Medical clinics of North America, 67(4), 845.

Little, M. H. (2006). Regrow or repair: potential regenerative therapies for the kidney. Journal of the American Society of Nephrology, 17(9), 2390-2401.