Both hyperkalemia and hypokalemia have adverse effects on the body's acid-base balance. In hypokalemia, the concentration of potassium in the extracellular fluid decreases, causing potassium to move from inside the cells to the extracellular fluid, while hydrogen ions move into the cells. The lack of potassium in the tubular epithelial cells of the kidney also leads to an increased secretion of hydrogen ions; hence, sodium-hydrogen exchange increases, and the reabsorption of bicarbonate is enhanced, resulting in metabolic alkalosis. Conversely, hyperkalemia can cause metabolic acidosis, as an increase in extracellular potassium causes potassium to move into the cells, while hydrogen ions in the cellular fluid move out. At the same time, an increased potassium concentration inside the tubular epithelial cells leads to metabolic acidosis.