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©2013 UpToDate ® Print Email Buffering in metabolic acidosis Mechanisms of buffering of strong acid infused intravenously in the dog. Fifty seven percent is mediated by cell buffers, resulting in the movement of sodium (36 percent) or potassium (15 percent) into the extracellular fluid or in the movement of chloride (6 percent) into the cells. Forty three percent of buffering occurs in the extracellular fluid, almost all by bicarbonate. Data from Pitts, RF, Physiology of the Kidney and Body Fluids, 3d ed, Year Book, Chicago, and from Swan, RC, Pitts, RF, J Clin Invest 1955; 34:205.