Reciprocal cation shifts of K+, H+, and Na+ between the cells, including renal tubular cells, and the extracellular fluid. In the presence of hypokalemia, K+ moves out of the cells down a concentration gradient. Since the cell anions (primarily, proteins and organic phosphates) are unable to cross the cell membrane, electroneutrality is primarily maintained by the entry of Na+ and H+ into the cell. The increase in cell H+ concentration may be responsible for the increased H+ secretion and HCO3– reabsorption seen with hypokalemia. On the other hand, hyperkalemia causes H+ and Na+ to leave the cells, resulting in a fall in H+ secretion and HCO3– reabsorption.
Graphic 60830 Version 3.0
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