Why does hypokalemia cause abnormal acidic urine?
Hypokalemia is characterized by a reduction in the concentration of potassium ions in the extracellular fluid, which causes the transfer of three potassium ions from inside the cells to the outside, while two sodium ions and one hydrogen ion move from the outside to the inside of the cells. Due to the decreased concentration of hydrogen ions in the extracellular fluid, metabolic alkalosis can easily occur. At the same time, due to the reduction of blood potassium, the potassium-sodium exchange in the renal tubules decreases. Renal tubular cells secrete more hydrogen ions to exchange with sodium ions, and the reabsorption of bicarbonate ions increases, raising the pH value. This metabolic alkalosis increases the number of hydrogen ions inside the cells and the kidney's hydrogen secretion, thus making the urine acidic, often referred to as paradoxical aciduria.
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