hyperkalemia and acidosis

[usmletoo]

please need help understanding this
So both acute and chronic metabolic acidosis have hyperkalemia- but in acute not enough time to fully compensate low renal excretion of K and K balance is positive - in chronic enough time to compensate lots of Hco3 are being made alot of H+ are pumped this neutralizes the charges in the membrane - this stops attracting H+ and K+ , so no secretion ...so what I don't understand is why renal excretion of K is high and the K balance is negative...
can someone explain PLEASEEE
thanks

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[kunfu]

I'm having some trouble understand exactly what your asking. But it seems like you may be forgetting a key fact. The hyperkalemia from acidosis is the result of a shift of K out of the cells into the plasma, in exchange for H ions. Hence if renal excretion of K is increased it is possible to have a negative K balance while still having a high level of K in the blood (Hyperkalemia).

 

[usmletoo]

thank you for taking the time to answer my question

so I agree with you - but why does it say there- acute- low K excretion / positive balance- and Chronic - high K excretion / negative balance?
help pleaseee
thanks

 

[kunfu]

thank you for taking the time to answer my question

so I agree with you - but why does it say there- acute- low K excretion / positive balance- and Chronic - high K excretion / negative balance?
help pleaseee
thanks

Im not sure but my bet is that in a chronic condition you have more K building up in the plasma, as more and more K leaves the cell. As a result K excretion increases to maintain K levels in blood. Remember K levels must be kept relatively constant to avoid arrhythmias and all sorts of problems. In an acute case the K levels in the blood havent risen enough to cause significantly increased secretion.