Changes in plasma potassium concentration during acute acid-base disturbances

It has been widely held that the changes in plasma potassium concentration observed during acute acid-base disorders are solely determined by the associated changes in blood acidity. However, a critical examination of the literature uncovers wide differences among the four cardinal acid-base disorders with respect to the associated changes in plasma potassium concentration. In fact, the data suggest that a host of factors other than the attendant changes in plasma hydrogen ion concentration may well modulate the intercompartmental distribution of body potassium during acid-base disorders. In this study we review the qualitative, quantitative and mechanistic aspects of the plasma potassium response to acute alterations in blood acidity.