ALDOSTERONE-ALKALEMIA & POTASSIUM

SUMMARY

1. 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).

2. This can result in "paradoxical aciduria," a low urine pH in the setting of metabolic alkalosis.

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

Reference(s)

Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].