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Clinical assessment of acid-base disorders depends on measurements made in the blood, part of the extracellular compartment. Yet much of the metabolic importance of these disorders concerns intracellular events. Intracellular and interstitial compartment acid-base balance is complex and heterogeneous. This review considers the determinants of the extracellular fluid pH related to the ion transport processes at the interface of cells and the interstitial fluid, and between epithelial cells lining the transcellular contents of the gastrointestinal and urinary tracts that open to the external environment. The generation of acid-base disorders and the associated disruption of electrolyte balance are considered in the context of these membrane transporters. This review suggests a process of internal and external balance for pH regulation, similar to that of potassium. The role of secretory gastrointestinal epithelia and renal epithelia with respect to normal pH homeostasis and clinical disorders are considered. Electroneutrality of electrolytes in the ECF is discussed in the context of reciprocal changes in Cl- or non Cl- anions and HCO3-. [ABSTRACT FROM AUTHOR]

Highlights from the article: Regulation of acid-base balance has been a research topic of great interest for more than a century. Recognition of the importance of the hydrogen ion concentration for the chemical and enzymatic reactions that are at work in animal physiology led to sometimes conflicting theories and mechanistic definitions of acid-base balance and associated clinical disorders. The understanding of the relationship between acid-base balance and tumor cell growth has led to modern views of the regulation of neoplastic cell growth.