Compensation

Substantial evidence shows that American CEOs are better rewarded than their counterparts in European countries, and that this trend has been on a rapid upward growth starting from the last thirty years and only slowing down during global economic recessions. As expected this trend has drawn considerable arguments, with a lot of questions posed about what structures do American companies usually apply when commissioning such abnormal pay hikes and whether such structures are ethically and professionally justified.

For instance, it can be loudly wondered whether the American CEOs deserve these high payments more than other CEOs elsewhere in the world. It can also be wondered whether they have more responsibilities than their counterparts in Europe and other continents alike. Well, the answers to these questions may draw all sorts of answers to the affirmative and/or otherwise.

For purposes of this paper it is hypothesized that, the abnormally huge compensation packages given to American CEOs in the form of salaries, bonuses, stocks, options, or even termination packages is not morally justified given that most workers in America are still struggling with the agony caused by unemployment, ineffective social welfare systems, and increased costs of living. In tackling this seemingly sensitive issue, efforts will be made to represent both sides of the argument in equal measures and then finally a final verdict will be made in support of the study hypothesis.

Theoretical Framework: Rogerian Argument Himself a psychologist, Carl Rogers advances a “rational” kind of approach especially when sensitive matters are at stake. He opines that a writer should first of all understand strive to represent his readers perspectives in his writings using the most neutral words there can be. He should also do the same when advancing his standpoint on an issue, particularly if such standpoint is not good news to his readership.

His advices are that a writer should not adopt an adversarial approach in presenting arguments rather he should adopt a seemingly neutral ground that will help to build sympathy and the desire to read more on the part of the audience. In fact, he reasons that a writer should not make a generalization as what his readership should believe of do, rather he should together with his readership struggle to finding and defending a neutral ground that will enable the readership to make their own personal decisions based on the fairly and factually resented issue.

Using this practical method of argument this paper will seek to present the sensitive issue of executive compensation by delineating the issue in operational terms; agreeing on morality of increased CEO compensation packages; refuting the morality of the same; offering examples why increased CEO compensation packages is not morally justified, and; proposing a neutral compromise that pits the two positions equally acceptable to the audience. Research Problem Is it morally justified to pay CEOs huge salaries while other employees are poorly rewarded?

This paper intends to carry out an intensive study to investigate whether the evidential abnormal American CEO Compensation packages are morally justified. To achieve this, a range of existing literature on marketplace modalities governing employee compensation vis-a-vis ethical structures will be revisited. The literature collected thereof will be analyzed and systematically presented using the five principles of communication as advanced by Carl Rogers with view of advancing an opposition verdict.

There is a general consensus that teachers are underpaid and their professions are under respected. Now what if I told you that presidents of colleges make a lot of money? And that they have been making more money since the recession even though campuses at large have lost classes and fees have been increased for students. Do you feel that the presidents for scholastic institutions should still get paid so highly? Well, it all boils down to the general perspective held by an individual. Most European countries believe in a more socialistic approach to president/CEO/executive pay.

Their salaries represent a level of contentment and achievement that can be justified as being equal to their counter parts below them. Here in America, since the recession many Americans have been scratching their heads in wonderment as to why CEOs of companies such as CountryWide, BofA, and Goldman have been pulling in such large amounts compared to the rest of the workers. Brian Foley mentioned that many American CEOs make more money in one year than the median salaried worker makes in lifetime. Is this an injustice? Our European corporate counterparts see it as such.

However many European companies move their base to America to reap the same rewards that American CEOs get, so what part of making such high pay makes it right? As a student and an intern at a finance company I feel that the corporate pyramid represents more of a stairway to heaven. I wonder what part of life, morality, and injustice to my coworkers must I face to reap the future rewards of possibly being a partner or maybe more? Should I work for the money as many Americans do instead of our European counterparts who work for contentment and the ability to provide security to their employees and others?

With the on set of the recession American corporate pay structure has not only been heavily scrutinized by those who are not in the top of that structure, but has also been shunned upon by many other CEOs and Presidents all over the world. Greedy for money, unjustly leaning towards the welfare of Top executives, immoral for people who are unemployed because a CEO is unwilling to hire new members to keep his salary as high as possible; these are the ideas that resonate in newspapers.

Although after being an intern at KKR Capital for one and half years and getting paid at 25 an hour, my sentiments are starting to be different. Background Information There is no doubt on the authenticity of the generalization that, CEOs in American corporations (profit and not-for-profit alike) are rewarded handsomely compared to what their counterparts in other countries particularly those in Europe earn. Consequently, significant debate on this seemingly sensitive issue has ensued among policy makers and pundits alike within and beyond the US borders.

Tellingly, some of these loud voices in acknowledgement as well as those in opposition have got some elements of sanity in them. After all, common sense as well as sound work ethics holds that employee compensation packages should be pegged against performance meters. In their investigation on the patterns of executive compensation among “S&P 500, Mid-Cap 400 and Small-Cap 600 companies” between the period commencing 1993 to 2003, Bebchuk and Grenstein found out that indeed there has been a tremendous increase in remuneration packages for CEOs and top executives across major organizations in the United States (2).

Their findings pointed out to a whopping mean compensation increment of 146 percent for CEOs in the S&P 500 category, the mean compensation for “top-five executives” also grew by a 125 percent margin from $9. 5 to $21. 4 for the same category. An increase from the $3. 7million recorded in 1993 to $9. 1 million recorded in 2003. Similar upward trend was also observed in the Mid-Cap 400 and Small-Cap 600 company categories.

A comparison of the mean compensation increase between CEOs and the top-five executives indicated that CEOs were higher in 2003 when compared to 1993, an indicator that indeed CEOs compensation packages has grown over the years (2-3). Faulkender et al argue that CEO compensation in majority of the leading US organizations has soared to reach higher levels courtesy of “an explosion in stock option grants” and “flawed governance mechanisms in the pay-setting process” (110). Precisely, their data shows that the mean CEO remuneration package for S&P 500 corporations grew significantly from a low of $850,000 to $14 million between 1970 and 2000.

For unexplainable reasons the growth dropped in 2002to $9. 4 million only to gain momentum again to hit the high of $13. 5 million between 2005 and 2007 (110). Again, it dropped in 2008 to $10. 5 due to the biting effects of the global economic crunch. [See appendices 2 for amore details] There is a huge discrepancy between CEO salaries and those of other employees. Trends show that the discrepancy has been on an increase starting from the last thirty years and only slightly dipping on few occasions due to the effects of unfavorable economic developments.

As a matter of fact, unusually high salary packages have been ditched even on controversial circumstances to executives embroiled in management squabbles. In mind is the notable $210 million that was given to HomeDepot departing executive, Robert Nardelli and the $187. 5 million given to NYSE departing executive Richard Grasso. In the list of the “most controversial compensation packages” issued to an executive is the former Tyco CEO, Dennis Kozlowski who was given a dispatch package of $5.

1million worth of shares in the company and other shares from a subsidiary company worthy $81 million despite him being not cleared from fraudulent charges brought against his manner of management while serving as the company CEO (Faulkender et al). Morality in American CEO Compensation Kaplan (2009) argues that, the widely held notion that CEO compensation packages are abnormally high is nowhere near the truth, and that CEO compensation packages do not contribute to financial crises.

He offers what seems like a set of well researched and analyzed data showing that CEOs are actually underpaid particularly when their compensation packages are juxtaposed against those of “hedge fund managers, investment bankers, private equity investors, money managers, and lawyers”. In fact, in 2007 S&P 500 CEOs earned relatively low salaries compared with what top hedge fund managers took home. In his well broken down analysis, he offers that the salary scales of other employee groups just as that of the CEOs has grown considerably since 1990s.

Analytically, this is an indicator that CEOs are not riding on an abnormal or even unethical reward wave. Contrary to other studies on CEO compensation trends among American corporations, Kaplan concise research findings show that CEO salaries among major US S&P 500 companies only gained momentum in 2000and that since then the mean and median CEO compensation indexes has been on a stagnant as opposed to a growing trend. Even so, in what seems as a concurrence with other studies on the American CEOs compensation matter, Kaplan agrees that since 2008 the trend has been on a decline trend.

Moreover, as opposed to the gross income trends entered in the prior decade, CEOs only made a small portion, three percent of the number of Americans making the top 0. 1 percent gross income in the 2004- 2005finacial year. That the S&P 500 CEOs only managed to account for about 0. 60 percent of the total income for Americans making the top 0. 1 percent gross income in 2006 as compared to 1. 2 percent registered in 2001, with indicators showing a likely diminishing trend in the future. According to Bebchuk, Fried and Walker any ‘rational’ human being including CEOs may be tempted to enrich themselves if given an opportunity to do so.

They argue that, “When changing circumstances create an opportunity to extract additional rents–either by changing outrage costs and constraints or by giving rise to a new means of camouflage–managers will seek to take full advantage of it and will push firms toward an equilibrium in which they can do so”(cited in Gabaix and Landier 53). A case atypical to this postulation is the popular use of the stock option packages by CEOs to increase their benefits without undergoing the agony of facing shareholders vetting and/or wraths.

Moreover, the behavior of the board members also gives CEOs a leeway to sneak in high incentives for their positions. Incomplete or ill-informed board members may fail in their duties to vet any salary increases on the part of the CEOs giving them a wide operating space. Some board members may also be lacking the needed powers to question CEOs compensation decisions; this is a case common in corporations with very powerful CEOs who tend to ‘manage’ the board. There is no direct link between financial crisis and high executive compensation.

Though it is obvious that high remuneration packages may play a significant role in financial crisis engulfing companies such as the one witnessed in 2008, other more directly linked and more powerful factors are responsible. In mind is the weird banking regulation that leaves too much space for financial institutions to give out unsecured credit facilities as well as the great leeway on the part of such banking institutions that accords them an opportunity to double as hedge funds.

By fair terms these two factors are the ones to blame and not the hiked executive salaries given that the financial crisis was chiefly caused by high rates loan and mortgage defaulting. As a matter of fact, Faulkender et al (116) argue that executive compensation forms a very small chunk of the many causal factors of the recently ended financial crisis and that it cannot be blamed for all the woes engulfing the American banking industry. According to Grundfest executives of banks experiencing financial crises cannot be held accountable for causing the crises.

In fact, he boldly offers the executives incentives cannot be blamed for financial crisis that hit the banking sector in 2008. This he defends by offering that the executives always give their best when it comes to managing their organizations and that they formulate strategies that are based to the best of their knowledge and experience: “Sure, they were miserably wrong, but they didn’t know they were making a huge mistake that would cost them, their shareholders and taxpayers a huge fortune” (1).

He defend this argument by reminding his readership that even the executives lost their investments in the form of stock they held in the banks. That the executives are also shareholders of the organizations they head, it is an indicator that they do not their own interests but that of the shareholders and that any eventuality of a great financial crisis is just normal in that it is not triggered by any commission or omission on the part of the executives (1).

The high CEOs compensation packages among American public corporations are ethically justified. The competitive nature of the domestic market economy between privately owned equity firms and public corporations where private organizations offer very competitive pay packages to woe top executive with proven performance track records. A case atypical to this argument is depicted by the mass exodus of top executives from public corporations to Wall Street based private equity corporations where they offer a range of executive advisory services (Kaplan 1).

American CEO Compensation Immoral Is American CEO Compensation moral? I believe that it is immoral because compared to that of European CEOs, American CEOs get paid so highly and with the onset of the recession, this has been highly scrutinized. It is argued that executives who by capitalizing on the seemingly lax regulations on the compensation modalities go ahead and declare abnormal bonuses for themselves are result-oriented as opposed to rule-oriented.

Lundberg and Montell proves this postulation by asserting that the growing trend on the part of executives to reward themselves with hefty salaries is occasioned by the market systems, particularly those based on commission basis or the popular “performance-based” remuneration. Analyzing a number of similar trends they argue that the performance-based salary perks erode the moral content among executives to the extent that they fail to link their actions as unethical but economically justified, given the huge profits they help make for the companies they head (2).

Financial incentives are responsible for attracting all manner of personnel some of whom are only driven by the desire to reap from the huge legitimate benefits and if possible to use the seemingly ambiguous employee compensation regulations to achieve this in a quicker manner (Schwab 1). As a matter of fact, it has been argued that incentivized compensation packages are usually complex especially if large production processes are involved so that it becomes difficult in determining the “what, how much, who, and when” of production units awarded to individual employees.

Such complex scenarios may tempt executives to overstep their powers and therefore increase their salaries. Moreover, though the performance-based compensation scheme is buoyed by the notion that highly rewarded employees perform better this is may not be the case in all situations especially if some of section of the employees is rewarded handsomely at the expense of others.

Paying executives too much money is tantamount to immorally siphoning a large chunk of the overall profits that an organization makes and spending it on one individual instead of doing so on the large number of the shareholders who are in real sense the owners of such organization. This trend which has been witnessed in many financial institutions in the US has resulted in immense suffering on the part of the shareholders. It can be argued that these sufferings are threefold (Murali 1):

First, from the poor decisions taken at the expense of the long-term viability of the company; second, through the payouts of excessive benefits for mediocre or poor performance; and third for the costs and settlements of any ensuing lawsuits, which were paid by the companies involved. Most importantly, these skewed compensation packages do not subscribe to any conventional capitalism rules. This is because it flouts the tenets of performance-based reward system as it does not make sense that American CEOs are the only hardworking executives in the whole world.

As Murali summarizes it, “There is no way that the job of CEOs in the US has become 20 times more difficult than it was in Alfred Sloan’s day or 10 times more difficult than it was in the 1970s, and yet the packages suggest precisely that” (1). There is no doubt that the American government does not give much attention to executive compensation practices employed by major corporations operating the US. This has given much room to large financial institutions to engage in unprecedented reward systems that enrich top executives at the expense of the other cadres of employees and the shareholders.

Such, reward system is not only selfish and immoral but it also highlights on the bred of CEOs running large corporations: as persons out to perpetuate their own agendas rather than that f the shareholders. Mitigation Measures It is true that in approaching the American CEOs compensation issue a lot of care and sobriety should be used. This is because there are both light and dark sides on the issue. The most certain solution to the issue seems to be legislation of strict regulations that will put limits to the amount of bonuses executives can award themselves.

However, this need not be as plain as it is said; otherwise it will not be accepted by the majority. Americans needs fundamental economic legislations that will address a wide area of the puzzle including making the cost of living more affordable for the common American so as to mitigate the biting effect of economic of future economic crunches. Such legislations will ensure that the executive compensation packages are also fixed in accordance with the prevailing economic trends as opposed to the individual performance of a company.

In regard to their “result-oriented and rule-oriented” analogy, Lundberg and Montell offer that result-oriented executives are most likely to disregard the moral fabric when compared to their rule-oriented counterparts. In this regard they opine that the performance-based incentive programs are a recipe for moral degradation on matters of employee compensation and that they only succeed in creating result-driven executives and not rule-conscious ones (Lundberg and Montell 2).

It can therefore, be asserted that even in the presence of rules that fix executive compensation limits, there can never be a convincing assurance that the problem of abnormal compensation can be fully addressed given that, the inherent failure on the part of the result-driven executives to acknowledge the element of morality in following or even breaking the set rules. Again, the bonus pegged market structure where both short and long term bonus targets are included as part of competitive reward system to motivate hardworking employees, and to attract and retain talented employees’ only serves as a catalyst for breach of such rules (2-3).

This postulation is supported by Schwab (1) when he says: While regulation is important for the future of the global economy, rules alone are not sufficient. The economy is not an independent or self-contained realm; the crisis has shown that the economy has to serve society. We have to be careful that the measures taken to curtail the crisis will not damage the power of innovation in the real economy. In mitigation it is hereby advanced that the realm of management should not be commoditized, rather it should be handled as a profession.

This postulation is advised by the conventional wisdom that a profession just like a society is governed by “ground rules” and not monetary incentives. Such a scenario will accord all cadres of employees an opportunity to reap from the fruits of their labor in proportionate measures irrespective of their status in the organizational ladder. Most importantly, this “will create an unspoken social contract of trust to other members of society” (Lundberg and Montell 4). This postulation draws its impetus from similar sentiments shared by Schwab (1) when he generously offers that:

When I had surgery a few years ago, I knew very well that my future quality of life would be dependent to a large extent on the qualifications of the surgeon. This is why I sought an expert who was the best in his profession. I naturally assumed that I was in the hands of a doctor who could apply his most professional skills without claiming that he would like to have a share of my future income – since, of course, this would be dependent on his knowhow – in addition to his remuneration.

In this regard Reynolds offers that organizations should foster efforts toward the improvement of personal qualities such as educational qualification, work experience, as well, the propensity to embrace change. He argues that such efforts are capable of instilling the sense of morality among employees (241). Work Cited Bebchuk, Lucian and Yaniv Grinstein. The Growth of Executive Pay. Discussion Paper No. 51004/2005, Harvard Law School Cambridge, MA 02138, (2005). Faulkender, Michael, Dalida Kadyrzhanova, N.

Prabhala, and Lemma Senbet. Executive Compensation: An overview of research on corporate practices and proposed reforms. Applied Corporate Finance, 22. 1. (2010). Co Gabaix, Xavier and Augustin Landier. Why Has CEO Pay Increased So Much? The Quarterly Journal of Economics, February 2008. Grundfest, Joseph. ‘What’s Needed is Uncommon Wisdom’, New York Times online, October 6, 2009. Kaplan, Steve. (Good) CEOs Are Underpaid, Harvard Business Review, Harvard Business School Publishing, June 15, 2009.

Lundberg, Viktor and Christofer Montell. The effects of incentive compensation on moral awareness: An explorative study. Master Thesis in Management Accounting, University of Gothenburg, School of Business, Economics and Law, 2010. Merchant, Kenneth, A. , and Wim A. Van der Stede. Management control systems: Performance measurement, evaluation and incentives. Essex: Pearson Education Limited. Murali, D. Pay should reinforce right tone at the top.

July 8, 2010, accessed July 22, 2010, from: http://www. thehindu. com/ Reynolds, Scott. Moral awareness and ethical predispositions: investigating the role of individual differences in the recognition of moral values. Journal of Applied Psychology 91. 1 (2006); 233–243. Schwab, Klaus. Financial crisis is a chance for positive change. Times Online, Publ. 081104. Accessed on July 22, 2010, from: http://business. timesonline. co. uk/tol/busines/management/article5076011. ece/

Introduction

Acid-base balance in the human organic structure refers to the ordinance of the free H ions present in the organic structure fluids [ 1 ] . This balance is important to the continuance of life as it influences many different systems and mechanisms in the organic structure. The mean pH of the blood when all the homeostatic controls are working efficaciously is 7.4. The pH of normal arterial blood is really 7.45 whereas the pH of normal venous blood is 7.35. This difference can be accounted for by the fact that when CO2 is picked up by tissue capillaries, this leads to the coevals of H2CO3. This in bend generates H+ doing the blood more acidic [ 1 ] . It is partially due to the actions of the kidneys which helps maintain the blood within theses rigorous bounds.

All reactions affecting enzymes will necessitate that the pH of organic structure fluids remains within a narrow scope. The function of the kidneys in keeping this homeostasis is of import, but is seen as the “ 3rd defense mechanism ” , the first being the usage of chemical buffers in the organic structure and the 2nd being changes made in take a breathing which changes the pCO2 ( partial force per unit area of C dioxide ) and hence the concentration of H ions in organic structure fluids [ 2 ] . In this study, I will depict the changes that the kidneys make in seeking to modulate this balance, how the anatomy of the kidney maps to drive these mechanisms and the response of the kidneys when the organic structure experiences acidosis of alkalosis.

Besides as portion of my study, I will discourse the effects that a high protein, low saccharide diet has on the acid-base balance of the organic structure, how this is later corrected utilizing nephritic homeostatic mechanisms, the possible nephritic pathology that can happen as a consequence, and the consequence this will hold on nephritic compensation of acid-base balance thenceforth.

Important anatomy of the kidney

The kidneys are the variety meats which are chiefly responsible for the production of urine, before it passes through the ureters to the urinary vesica in the pelvic girdle. The kidneys are located within the right and left wing and situated retroperitoneally to the spinal column, between the spinal degrees of T12 to T13. The kidneys are about 11-14cm lengthwise and the kidney situated on the left side is found to be more inferior. The kidney consists of uriniferous tubule fractional monetary units, of which there are around 1million present . But it is the internal constructions of the kidney which are of most involvement in relation to the care of acid-base balance ; peculiarly the function of the proximal tubule, type A and B intercalated cannular cells found in the distal and connecting tubules, and the peritubular capillaries. Figure 1 below is a diagram which depicts the cross-section of a kidney and the functional anatomy.

Blood is supplied to the kidneys through the nephritic arterias, which branch straight from the abdominal aorta. Branching occurs once more one time within the kidney. One group of these sub-branches are the interlobular arterias. These run through the nephritic cerebral mantle and subdivision once more to organize the sensory nerve glomerular arteriolas which supplies oxygenated blood to the glomerular capillary bed and besides, the motor nerve glomerular atrerioles. Within the nephritic cerebral mantle, some of these motorial glomerular arteriolas form the web of peritubular capillaries. These capillaries can either have secreted ions from the intercalated cells, or they can pump ions into the nephritic cannular lms, from where they will be transferred into the urine.Figure 2 below shows a simplified diagram of the uriniferous tubule, nevertheless efficaciously describes the chemical exchanges which take topographic point.

Intercalated cells

Intercalated cannular cells are found in the epithelial tissue of the collection and distal tubules, along with chief cells. The cells found in these tubules, along with all other nephritic tubules are cubelike epithelial ( one exclusion is the lms of the thin limb of the cringle of henle where the cells are level ) . But it is entirely the intercalated cells involved in keeping acid-base balance. The intercalated cells can nevertheless be classified farther, into Type A and Type B. We are able to make this due the fact that these cells have different transporter proteins [ 7 ] .

Type A intercalated cells – These cells are more active than type B and act in order to forestall a province of acidosis. This is done by

1. secernment of free H+
2. resorption of HCO-3
3. Resorption of K+.

Hydrogen ions are secreted from these cells via an H+/ATPase transporter, a proton pump, which actively secretes them. The Reabsorbtion of K+ ions occurs along side this procedure. It should besides be noted that the presence of aldosterone, which elevates the activity of the H+ -ATPase pump, increases the rate of H+ secernment.

Type B intercalated cells – These cells act in order to forestall a province alkalosis. This is done by

1. Secretion of HCO-3
2. resorption of free H+
3. secernment K+.

Alternatively of the proton pump, these cells contain an H+-ATPase pump. This complex actively transports H+ ions back into the peritubular capillary from the nephritic cannular lms. But the most of import map of these cells is the secernment of HCO3- ions from the peritubular capillary into the nephritic cannular lms for elimination. This occurs in the apical membrane of the cell, where the HCO3- ions are exchanged across the membrane. The transporter through which HCO3- ions are exchanged is non the same as the pump that is utilised in type A intercalated cells.

These cells work in sync in order to keep the right balance.

Proximal tubule

The cells found in this tubule are besides cubelike epithelial cells, nevertheless, these cells differ from the cells found in the nephritic tubules as they have a brush boundary line of microvilli. This provides a larger entire surface country for the transportation of substances across the cell membranes. Many chondriosomes are besides seen in these cells histologically, in order to supply energy for procedures affecting active conveyance. Physiologically, the proximal tubule has two chief functions. First, to resorb from the glomerulus any hydrogen carbonate ions which have been filtered. The proximal tubule is the chief site of bicarbonate resorption, with 85-90 % of the filtered hydrogen carbonate being reabsorbed here. Second, it is the primary site of ammonia production. The huge bulk of this production is done within the proximal tubule.

Both of these mechanisms will be discussed in more item in the undermentioned chapters.

Nephritic mechanisms of acid-base balance

The excess nephritic homeostatic mechanisms of acid-base ordinance consist of ; the pneumonic ordinance of pCO2 and buffer systems found in the blood and intracellularly. Interaction does take topographic point between these mechanisms and the action that the kidneys take in keeping acid-base balance. There are three factors which are regulated by the kidneys refering acid-base balance:

H+ elimination

HCO-3 elimination

NH3 secernment

It should be noted that these factors are interrelated and there is no isolation when it comes to keeping their degrees in the plasma. The purpose of the kidneys is to keep the physiological acid-base ratio of 1:20. This being the ratio between CO2 ( which becomes H2CO3 when dissolved in the plasma ) and HCO-3. Although the three factors mentioned above are physically changed, it is the concentration of HCO-3 which is ever altered during each mechanism, doing it the common denominator that influences plasma acid-base balance. In a instance of acidosis or nearing acidosis, the buffers can merely make so much to battle the alteration in pH. The anatomy of the kidney involved in releasing H+ ‘s into the piss, in order to be ejected from the organic structure are the proximal, distal and roll uping tubules. The anatomy of which is described above. These H ions are derived from CO2 found in one of three topographic points ; the plasma, the cannular fluid or from the intercalated tubular cells where it is synthesised due to metabolic procedures .

Bicarbonate ions are besides synthesised in the cannular cells from CO2 and H2O, and this reaction is catalysed by the enzyme carbonaceous anhydrase. But the kidney has two functions with respect to bicarbonate ions ; it is involved in the resorption of filtered hydrogen carbonate ions and the elimination of hydrogen carbonate that has been synthesised from its constituents.The site of this resorption within the kidney is found chiefly in the proximal tubule, but there is grounds of this taking topographic point at the distal and convoluting tubule and thick go uping limb of the henle. At the nephritic atoms, Bicarbonate ions are easy filtered. But in order to forestall organic structure fluids from going greatly acidic, most of these ions must be reabsorbed [ 12 ] . This is the destiny of the huge bulk of these ions, with merely around 0.1 % being lost in the urine. However as mentioned, the creative activity of new hydrogen carbonate ions occurs within the cannular cells of the kidney. This procedure takes topographic point each clip there is

1.  secernment of ammonium and
2. the elimination of acid. From the cannular cells, the hydrogen carbonate ions are absorbed into the peritubular lms.
3. Ammonium secernment is a utile manner in which the kidney can egest more H ions, as it does non affect the demand for organic buffers.

The ammonium that is utilized is derived from the dislocation of protein. However as ammonium is toxic even at comparatively low degrees, in the liver, the ammonium ion is bound to a hydrogen carbonate ion in the signifier of either Urea or Glutamine. Once the glutamine is passed onto the proximal tubules in the kidney, the ammonium ion is released, ready for usage. The demand for this ammonium is due to the fact that the kidneys can non overload the piss with H ions because the urine pH can non be decreased lower so 4.5. The ammonia Acts of the Apostless as a secondary buffer in this sense, along with a phosphate buffer, which is besides present in the cannular fluid.

The purpose of these mechanisms is to forestall the oncoming of acidosis or alkalosis. Acidosis and alkalosis can be classified, depending on which factor have been changed and the cause of this alteration. If the first alteration was in pCO2, either an addition or a lessening, the status will be known as either respiratory acidosis or alkalosis. Whereas if it is a alteration in hydrogen carbonate or H concentration, this will either be metabolic acidosis or alkalosis.

The physiological effects of the pH of organic structure fluids rolling outwith the rigorous physiological bounds can hold body-wide systemic effects. For illustration ; fluctuations in the concentration of H ions can change the irritability of certain nerve cells. It besides can hold effects on enzyme activity and K+ degrees in the organic structure fluids [ 1 ] .

Nephritic compensation of the systemic effects on acid-base balance, caused by a high protein, low saccharide diet.

This diet has come into the public oculus as a manner of cut downing one ‘s organic structure weight, whilst still being able to bask nutrients that would usually be seen as inappropriate if one was on a diet. The construct behind the thought is the remotion of simple saccharides from the diet, and replacing them with high animate being protein nutrient ( e.g sausage and bacon ) . It has been noted that the immediate alteration to this diet consequences in immediate weight loss. There is an lift in the rate of micturition, doing more Na to be lost, upsetting the balance of Na being taken in and Na being excreted. But the weight that is lost is due to H2O loss, non fat loss. The physiological response of aldosterone production brings the sodium/water balance back to normal. In the longer term, the degree of saccharide consumed is reduced to the point where, if there was a farther decrease in the ingestion of saccharides, a province of ketonemia would follow. In a survey carried out by Reddy et Al. suggests that a decrease in carbohydrate consumption along with a high protein diet will ensue in ” uncomplete oxidization of fat and attendant ketoanion production ” . The premiss behind this method of weight loss is that by cut downing the degree of saccharide available to the organic structure, fat will be oxidised in the liver to supply energy. In this state of affairs, it is the ketone organic structures produced by this oxidization of fatty acids that become the chief energy beginning.

Protein and carbohydrate metamorphosis

After protein has been metabolised by the liver, Urea is later produced. The optimal status for urea elimination is when there are low degrees of ADH in the plasma, forestalling most of the resorption of urea by the collection tubules. Dietary proteins which are ingested are broken down in the tummy by endo- and exopeptidases. The component amino acids are separated from one another by the dislocation of the peptide bonds. The amino acids are so taken up by enterocytes in the little bowel and transported to the blood stream.

The metamorphosis of sulphur-containing amino acids leads to the formation and construct up of ions which have an consequence on acid-base balance ( Cl, P, SO4 ). The ground that sulphur incorporating amino acids lead to an increased acid burden is that the oxidization of sulfur to sulphate green goodss protons. Therefore, an addition in protein intake consequences in an addition in the acid burden in the kidneys, due to the oxidization in the liver of aminic acids incorporating sulfur.

The organic structure ab initio responds with an addition in the net acid elimination, a lessening in the degree of bicarbonate ions excreted and an addition in GFR ( Glomerular filtration rate ) which later leads to an addition in ammonium elimination. The GFR is thought to increase due to a primary addition in nephritic capillary permeableness. This is a reaction to an addition in the degrees of N, due to amino acerb dislocation. However this mechanism is non plenty and as a consequence, blood urea N degrees addition. As the GFR additions, more energy is required by the kidney in order to go on to work efficaciously. In the kidney, the energy beginning is the amino acerb glutamine. The rate of its metamorphosis is increased, ensuing in an addition in the degree of ammonium hydroxide ( NH3 ) produced. As the acerb burden of the kidney and therefore figure of proton has increased, ammonium hydroxide, which has the ability to accept protons is released by cannular cells. The ammonia ions are oxidised to ammonium and extra protons are hence excreted in the piss in the signifier of ammonium. Increased degrees of acid and NH4+ are found in the piss, whereas the degree of bicarbonate ions beads expectedly. However, it should be noted that, as in response to any cause of increased nephritic acid burden, the cardinal stimulation for amminogenesis is the lessening in urinary pH. In some instances, the extent of ammonium elimination can do a ample urinary pH addition.

When saccharides are ingested as portion of the diet, the saccharides are usually found as polyoses. Starch and animal starch are normally obtained chiefly from works beginnings and meat severally. One of the other saccharides found in dietetic consumption, although less common, are the disaccharides. These larger units are broken down during digestion into their constituents. This is chiefly glucose. As a simple sugar, this can be easy absorbed by the enterocytes in the little bowel. The lessening in dietetic saccharides is instituted in order to do protein the primary beginning of energy, leting fatty acerb oxidization and ketone organic structure formation.

Nephritic pathology as a consequence of a high protein, low saccharide diet

As has been discussed, an addition in the degree of dietetic protein ingested increases the acerb burden in the kidneys. This addition can take to different abnormalcies and pathologies happening within the kidneys. Ketosis is associated with a high-protein, low-carbohydrate diet when there is drastic lowering of the saccharide consumption. As mentioned antecedently, ketone organic structures are produced upon oxidization of fatty acids. These build up in the blood watercourse. As the saccharide handiness has decreased, the organic structure becomes more and more dependent on fat shops as an energy supply, constructing up the degrees of ketone organic structures. This is seen as a plus point of the diet, as an increased figure of ketone organic structures leads to a loss of appetency. Ketosis has several complications which affect different systems in the organic structure. Some of which are desiccation, irregularity and a inclination to organize kidney rocks. More inauspicious affects include lipemia, faulty neutrophil map, ocular neuropathy and osteoporosis. The mechanisms of which will be discussed in more item [ 21 ] .

It has been suggested by Frassetto et Al. that due to a normal western diet, people are predisposed to a long-run, but low class acidosis. This is seen to be amplified in older people, where there is frequently a deterioration of kidney map and the kidney is unable to cover with an increased acid burden. This can frequently take to instances of metabolic acidosis. The underlying mechanism of this induced status is the increasing inefficiency of acerb elimination by the kidneys, and a lessening in the resorption of filtered hydrogen carbonate [ 22 ] . In the survey conducted by Frassetto et Al. analyzing the production of endogenous carbonaceous acids and the degrees of K and protein ions the diet, it was found that there was a strong nexus between carnal protein uptake and nephritic net acid elimination. This was non nevertheless found with vegetable protein. This reinforces the fact it is the consumption of sulphur-containing amino acids which has a greater affect on nephritic acid burden. The figure of sulfur incorporating aminic acids in veggie is much more varied.

There are some surveies which suggest that a high-protein diet can be connected with chronic kidney disease, due to the strain placed upon the kidney by such as diet. The cause of which is cited as the kidney being overworked when covering with some of the by merchandises of protein metamorphosis, for illustration the addition in Urea elimination, and holding to get by with an increased GFR. Chronic kidney disease can be defined as a state of affairs ” when the maps of the kidneys have been so reduced by a chronic disease procedure ”. This may be seen as a consequence of the cumulative effects of a high-protein diet. However it should be noted that there is difference among different surveies as to the badness of such a disease and which symptoms would be present, if it were to happen.

In chronic nephritic failure, the status can be exacerbated by a continued high-protein diet as this can take to increased keeping of certain ions, such as K or phosphate, which are released upon digestion of protein rich nutrients. If the patient besides has a instance of acidosis, this would decline a province of hyperkalaemia. The K found within cells is replaced with H ions, let go ofing more potassium ions into the organic structure fluids [ 24 ] . This is an illustration of how chronic kidney disease can come on due to increased kidney emphasis, brought about by an increased acid burden associated with a high protein diet.

Many surveies have now found a nexus between high-protein consumption and osteoporosis. The thought is centred on the fact that a high degree of protein in the diet leads to hypercalciuria, or high degrees of Ca in the piss. One of the beginnings of this Ca is from the soaking up of dietetic Ca in the bowel. However, this addition is non big plenty to propose that this is the ground for hypercalcinuria. It is believed that the beginning of this Ca is bone and hence as a consequence, there is a lessening in skeletal mass. One of the theories to explicate this provinces that, due to the increased acid burden that consequences, nephritic handling of this burden through amminogenesis is non plenty. Calcium arising from the skeleton is released to be utilised as a buffer, before being excreted in the urine . In the survey carried out by Frassetto et Al. in 2000 which looked at the hip break incidence ( HFI ) rate per 100,000 in adult females aged over 50 from states where per capita nutrient ingestion information was available, found that ” HFI in adult females over 50 is straight correlated with carnal protein ingestion ”. It should be noted nevertheless that there are surveies which suggest that a low-protein diet leads to a loss of bone-density. A survey done by Hannan et Al. found that ” lower degrees of protein intake were associated with significantly higher rates of bone loss at the hip and spinal column ”.

Specific nephritic pathology can be associated with this diet. One illustration is the oncoming of renal lithiasis or the presence of kidney rocks . As already mentioned, one of the side-effects of a high-protein diet is hypercalicuria. This is a hazard factor for renal lithiasis. Animal protein consumption is linked with other factors which besides increase the hazard. These include ; a lessening in the soaking up of base from the GI piece of land, taking to a lessening of citrate elimination in the piss. As with many jobs associated with a high-protein diet, low saccharide consumption merely worsens the state of affairs. A lower consumption of fruit and veggies reduces dietetic beginnings of base.

Decision

The kidneys and nephritic system are responsible for a broad assortment of maps impacting multiple systems around the organic structure. In relation to acid-base balance, although the kidneys act in concurrence with other mechanisms to keep acid-base homeostasis, they must be working usually in order withstand even infinitesimal alterations in organic structure fluid pH, caused by pathology or diet. Although the actions of the kidney in acid-base ordinance can be categorised depending on the how the concentration of three chief ions are changed, in order for the mechanisms affecting these to be fulfilled, many different but specific chemical reactions affecting many different countries of nephritic anatomy and biochemical substrates have to take topographic point. Physiological ordinance of acid-base balance can be greatly altered by an addition in dietetic protein intake, the effects of which are merely exacerbated by reduced saccharide consumption. Although the negative effects of such a diet were clear in all the diaries and text editions I have referenced, there is still elucidation needed as to the specific mechanisms of secondary pathology obtained after nephritic handling of this increased acid burden has diminished.