In omnivorous creatures, the diet is acidogenic, especially as a result of the
meat content, which gives rise to phosphoric and sulphuric acids, i.e., to metabolic acidosis.
In the short term, metabolic acids are buffered by tissue proteins and bicarbonate (the
‘alkali reserve’). In the longer term, acid must be excreted, or neutralized with base which
is also generated from the diet, by conversion of dietary amino-nitrogen to ammonia.
The final steps of this process occur in the kidney, which converts circulating glutamine to
ammonia, and to carbon products such as glucose and carbon dioxide, by metabolic
reactions which adapt during acidosis to generate more ammonia and maintain an
increased renal ammonia content. The complex mechanisms which govern the formation of
ammonia, glucose and carbon dioxide from glutamine, involving the reactions of amino
acids, the tricarboxylic acid cycle, and gluconeogenesis, are reviewed.