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POTASSIUM & ACID-BASE BALANCE

Nephrology

POTASSIUM & ACID-BASE BALANCE

PROXIMAL TUBULE
1. Na+/H+ counter-transporter is affected by the potassium concentration.

2. Hypokalemia: stimulates H+ secretion (anion ‘substitution’) & stimulates bicarb reabsorption - alkalosis.

3. Hyperkalemia: inhibits H+ secretion & inhibits bicarb reabsorption - acidosis.

DISTAL TUBULE
4. Aldosterone enhances distal sodium reabsorption by activating distal tubular Na + /H + and Na + /K + pumps at the expense of H + loss (alkalosis) and K + loss (hypokalemia).

INTRACELLULAR
5. In alkalemia, K+ shifts from the extracellular space to the intracellular space in exchange for H+, exacerbating hypokalemia.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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