What is the role of renal acid secretion in the pathogenesis of metabolic acidosis?

Updated: Oct 10, 2018
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Renal acid secretion is influenced by serum K+ and may result from the transcellular shift of K+ when intracellular K+ is exchanged for extracellular H+ or vice versa. In hypokalemia, an intracellular acidosis can develop; in hyperkalemia, an intracellular alkalosis can develop. HCO3- reabsorption is increased secondary to relative intracellular acidosis. The increase in intracellular H+ concentration promotes the activity of the apical Na+/H+ exchanger.


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