钾代谢障碍酸碱平衡紊乱

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1、DisordersofPotassiumMetabolismOutlineNormalpotassiummetabolismandregulationHypokalemiaHyperlalemiaCasediscussion1.thetotalpotassiumofbody:intracellular:98％（140-160mmol/L）extracellular：2％（3.5-4.5mmol/L）Normalpotassiummetabolism2.potassiumpresentsinthefood,suchasmilk,peanutpotatoes,s

2、altsubstitute.Potassiumexcretepathway:kidneythroughurine:90％Stool(feces):10％Sweatnormalserumpotassium:3.5-5.5mmol/Lbalancebetweenintra-andextracellularK+normal:15h3.regulationofpotassiumhomeostasisTranscellulartransferRenalregulation(1)PotassiumtranscellulartransferPump-leakmecha

3、nismfactors:PotassiumconcentrationinECFAcid-basebalanceInsulinCatecholamineOsmolarityExerciseTotalbodypotassium(2).RenalregulationforpotassiumexcretionGlomerularfiltrationReabsorptionbytheproximaltubuleandtheloopofHenleRegulationofpotassiumexcretioninthedistalandcollectingtubulesSo

4、dium-potassiumATPasePermeabilityofluminalmembraneforpotassiumReabsorptionincollectingtubulesHydrogen-potassiumATPase-protonpumpMechanismofpotassiumexcretionindistalandcollectingtubules:Influencingfactorsofpotassiumexcretionindistalandcollectingtubules:PotassiumconcentrationinECFAld

5、osteroneDistalflowrateAcid-basebalance(3)PotassiumexcretionincolonThesameastheexcretioninkidney4.physiologicalfunctionofpotassiummaintaincellularmetabolismmaintaincellularrestingmembranepotentialregulatetheosmolarityandacid-basebalanceDisorderofpotassiummetabolismNormalserumpotassi

6、um:3.5-5.5mmol/LHypokalemiaHyperkalemia5.influencingfacterofpotassiumhomeostasisacidosisalkalosishypoxiaseruminsulinserumdamageofcells[K+]ADS[K+]catabolismanabolismdistalflowratedistalflowrate1.Definition:Hypokalemiaisdefinedasadecreaseinserumpotassiumlevellessthan3.5mmol/L.Ⅱ.hypok

7、alemia2.causes(1).intake↓(2).discharge↑①digestivetract②kidneys：③skinGI:vomiting;diarrhea;GastrointestinalsuctionSkin:excessivesweatsfurosemidediureticlossesdiamoxdiureticphaseofARFrenal:primaryhyperaldosteronismlackofmagnesiumrenaltubularacidosisosmoticdiuresis(3).Abnormalitydistri

8、butionofpotassiummoveintoc