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Acid Base Effects on Renal Potassium
In acidosis, there is a K+/ H+ exchange in the cells, H+ moves inside the cells and K+ moves out of the cell leading to hyperkalemia. Hyperkalemia should increase the GFR/Filtered Load of K+ and therefore an increase in K+ excretion. However there is decreased K+ excretion in acute acidosis instead. The Kaplan video explains the increase K+ excretion in chronic acidosis is due to the increase GFR from the hyperkalemia. If that's the case, then acute acidosis should have an increase excretion of K+ as well because they are both hyperkalemic, but it's the opposite, there is a decrease in K+ excretion in aute acidosis. Can anyone explain this step by step?
In alkalosis, again there is a K+/H+ exchange in the cells, but this time H+ moves out of the cell while K+ moves in. Kaplan says that intracellular K+ would be increased in Acute alkalosis and Intracellular K+ would be decreased in Chronic Alkalosis. So if K+ moves into the cell during alkalosis, why would intracellular K+ be decreased in chronic Alkalosis?
Also in Alkalosis, since K+ moves into the cell, there should be hypokalemia in both acute and chronic alkalosis, so How would K+ excretion be increased in both acute and chronic alkalosis if GRF for K+ is decreased from hypokalemia?
If someone can answer these 3 questions giving the steps involved, that would be wonderful.
Last edited by JMT; 09-18-2007 at 05:26 PM.
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