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When blood potassium is higher than normal, what happens to bicarbonate conservation in the kidney?
AMore bicarbonate is conserved
BBicarbonate conservation is unchanged
CLess bicarbonate is conserved
DBicarbonate is excreted as carbonic acid
Answer & Solution
Correct answer: C. Less bicarbonate is conserved
1. Sodium is reabsorbed from the filtrate in exchange for a positive ion moving the other way.
2. Hydrogen ions and potassium compete for that exchange with sodium.
3. When potassium is abundant, potassium wins the exchange and enters the filtrate.
4. Fewer hydrogen ions therefore reach the filtrate.
5. Hydrogen ions in the filtrate are what convert bicarbonate into carbon dioxide for recovery.
6. With fewer of them, less bicarbonate is conserved and returned to the blood.
7. The mirror case holds too, so when potassium is low more hydrogen ions enter and more bicarbonate is conserved.
_Source: OpenStax Anatomy and Physiology (CC BY 4.0), Ch 26 "Fluid, Electrolyte, and Acid-Base Balance", section Renal Regulation of Acid-Base Balance_
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