Potassium Balance and Renal Transport Flashcards

0
Q

Say you eat a bunch of K+, why does your plasma [K+] only increase a little?

A

Most of it rapidly moves into cells, renal excretion of K+ happens more slowly.

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1
Q

Normal plasma [K+]?

A

4-5 mEq/L

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2
Q

Can cells better buffer a K+ deficit or excess?

A

They can better buffer a deficit, as K+ can move out of cells, but they can’t take up much extra.

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3
Q

If there weren’t cellular uptake, eating 5ish bananas would be lethal.

A

Ok.

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4
Q

3 hormones that affect “internal” K+ balance?

A

Insulin
Catecholamines
Aldosterone

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5
Q

How do insulin, catecholamines, and aldosterone all affect plasma [K+]?

A

They decrease it by stimulating that Na+/K+ ATPase.

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6
Q

How do exercise and cell lysis affect ECF [K+]?

A

They increase it.

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7
Q

How does ECF hypertonicity affect ECF K+? How?

Example of when this happens?

A

ECF tonicity causes movement of water out of cells.
K+ follows the water via solvent drag.

This can happen with hyperglycemia in diabetics.

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8
Q

How can acidemia cause acute hyperkalemia?

A

High levels of H+ can bind to pumps/channels normally occupied by K+.

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9
Q

Acidemia -> hyperkalemia.

Alkalemia -> hypokalemia.

A

This makes sense… because high ECF H+ will displace some intracellular K+, and vice versa.

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10
Q

2 ways K+ is eliminated?

A

feces, urine

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11
Q

Where in the nephron is most K+ reabsorbed, at fixed rates?

A

80% in the proximal tubule.

Another 10% in thick ascending limb…

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12
Q

Where in the nephron is K+ excretion/reabsorption regulated?

A

After the thick ascending limb…

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13
Q

The 2 different cell types in the collecting duct have different effects on K+. Which does which?

A

Principal cells: K+ secretion.

Intercalated cells: K+ reabsorption.

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14
Q

How do alpha-intercalated cells reabsorb K+?

A

K+/H+ ATPase (moves K+ in, H+ out into lumen)

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15
Q

How do principal cells secrete K+?

A

K+/Cl- cotransporter moves it into lumen.

16
Q

4 factors affecting distal tubule K+ secretion?

A

K+ intake, plasma [K+].
Aldosterone.
Distal tubule Na+ and flow.
Anions in tubular fluid.

17
Q

How does flow through distal tubule affect how much K+ is secreted? Why?

A

More distal tubule flow, more K+ secretion for any level of intake.
More Na+ removed -> more K+ moved into lumen.

18
Q

Why won’t eating lots of Na+ make you hypokalemic?

A

Because aldosterone will be inhibited.

19
Q

Why might sodium sulfate, if you gave it, cause hypokalemia?

A

Poorly absorbed anions will draw K+ into the tubule.

This applies to some drugs (and NaHCO3 at levels exceeding reabsorption capacities).