🏥 USMLE Exam Prep

In a patient experiencing metabolic acidosis, which of the following mechanisms is primarily responsible for the kidney's compensatory response to excrete excess acid?

A Decreased bicarbonate reabsorption in the proximal tubule
B Increased secretion of hydrogen ions (H+) by intercalated cells in the collecting duct
C Increased reabsorption of potassium ions (K+) in the distal convoluted tubule
D Inhibition of ammonia synthesis in the renal tubules

✓ Correct Answer: Option B

In metabolic acidosis, the kidneys compensate by increasing H+ secretion, primarily via the H+-ATPase in Type A intercalated cells of the collecting ducts, and by increasing ammonium (NH4+) excretion, which involves ammonia synthesis.

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