Interrelation of potassium and hydrogen ion gradients in metabolic alkalosis

¹ Department of Surgery, University of Kansas Medical Center, Kansas City, Kansas

To study the interrelationships of potassium and hydrogen ion intra- and extracellularly, as an extension of previous investigations on gastric alkalosis, metabolic alkalosis was produced in dogs by dietary K depletion, NaHCO₃ loading, and deoxycorticosterone administration, with and without chloride depletion. Analysis of skeletal muscle and measurement of intracellular pH confirmed the development of cellular K depletion, with increases of intracellular sodium and hydrogen ion associated with extracellular alkalosis and hypokalemia. These changes were not influenced by concomitant dietary chloride restriction. The intracellular K concentration was linearly and inversely related to the intra-extracellular hydrogen ion gradient. The intra-extracellular K gradient was about 10 times greater than the corresponding hydrogen ion gradient. These respective gradients were linearly related, in this proportion, over the range of K depletion studied in this type of metabolic alkalosis as well as that resulting from gastric juice loss. Deviation from this relationship occurred only with the most severe K depletion. These experimental observations demonstrate in vivo that the potassium and hydrogen ion gradients change in the same direction and are nearly constantly related in at least two types of metabolic alkalosis.

Key Words: intracellular pH • potassium deficiency • skeletal muscle • muscle electrolytes

Submitted on November 16, 1964