- Is caused by a decrease in respiratory rate and retention of CO2.
- Increased arterial PCO2, which is the primary disturbance, causes an increase in [H+] and [HCO3-] by mass action.
- There is no respiratory compensation for respiratory acidosis.
- Renal compensation consists of increased excretion of H+ as titrable acid and NH4+, and increased reabsorption of "new" HCO3-. This process is aided by the increased PCO2, which supplies more H+ to the renal cells for secretion. The resulting increase in serum [HCO3-] helps to normalize the pH.
- In acute respiratory acidosis, renal compensation has not yet occurred.
- In chronic respiratory acidosis, renal compensation (increased HCO3- reabsorption) has occurred. Thus, arterial pH is increased toward normal (i.e., a compensation).
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