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Physiology and Pathophysiology of Potassium Homeostasis: Core Curriculum 2019
Abstract
Total-body potassium (K+) content and appropriate distribution of K+ across the cell membrane is vitally important for normal cellular function. Total-body K+ content is determined by changes in excretion of K+ by the kidneys in response to intake levels. Under normal conditions, insulin and β-adrenergic tone also make important contributions in maintaining internal distribution of K+. However, despite these homeostatic pathways, disorders of altered K+ homeostasis are common. Appreciating the pathophysiology and regulatory influences that determine the internal distribution and external balance of K+ is critical in designing effective treatments to restore K+ homeostasis. We provide an up-to-date review of the regulatory aspects of normal K+ physiology as a preface to highlighting common disorders in K+ homeostasis and their treatment. This review of K+ homeostasis is designed as a resource for clinicians and a tool for educators who are teaching trainees to understand the pivotal factors involved in K+ balance.
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“We refer to this as a model of a man, instead of more generally as a human model, due to the known sex differences in renal K+ handling [24–26], ALD concentration [27], and plasma K+ concentration [28], all of which affect K+ homeostasis.”
From A mathematical model of potassium homeostasis: Effect of feedforward and feedback controls (2022) · cites this paper as [28]
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“POTASSIUM HOMEOSTASIS AND HYPERKALEMIA Potassiumhomeostasis is largelymaintainedby the kidneys, although the gastrointestinal tract and other systems are also involved to a lesser extent (Figure1).(7,10)Hyperkalemiahasdepolarizing effects on the heart,(10) causing shortened action potentials and increasing the risk of…”
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Metadata
- Authors
- Palmer, B. F., & Clegg, D. J.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Cedars-Sinai Medical Center (US)
- Corresponding author
- Palmer, Biff F.
- Venue
- American Journal of Kidney Diseases
- Publisher
- Elsevier BV
- Published
- 2019-11
- Volume
- 74
- Issue
- 5
- Pages
- 682-695
- ISSN
- 0272-6386 (ISSN-L)
- OpenAlex
- W2949599907
- Cited by
- 215
- References
- 0
- Citations by year
- 2026: 32 · 2025: 30 · 2024: 29 · 2023: 39 · 2022: 28 · 2021: 29 · 2020: 22 · 2019: 6
- FWCI
- 15.53
- Type
- journal article
- Language
- en
- Update notices
- erratum (2022-11-01)
- Open access
- closed
- Locations
- American Journal of Kidney Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Potassium and Related Disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ion Transport and Channel Regulation
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Keywords
- potassium homeostasis, total body potassium, potassium distribution, renal potassium excretion, insulin, hyperkalemia, hypokalemia, potassium disorders
- MeSH terms
- Curriculum, Education, Medical, Homeostasis, Humans, Hyperkalemia, Kidney, Kidney Failure, Chronic, Nephrology, Potassium
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