钾代谢紊乱chapter4 Disorders of Potassium metabolism.ppt

Chapter 4 Disorders of Potassium metabolism Osmotic pressure  What-phenomena? Why - flux? How –balance?  Concentration Osmotic pressure H2O H2O Na Na 1.Abnormally potassium concentration in the serum, 3.5 -5.5mmol/L introcellular fluid,140-160mmol/L 2.Physiology of K+ metabolism K+: 90%-- inside cells 7.6% in bone 1.4% in extracellular fluid 1% in transcellular fluid K+:the most important cation Homeostasis of potassium K+ K+ K+ PH [K+] Hormone …… Intake output Skin kidney 90% gastrointestinal tract 10% 50-200mmolin ECF 10mmol(1/4inECF) How to keep the balance in and out of the cell? Mechanism: pump-leak Pump:Na-K-ATPase move from low concentration to the higher Leak:K + channel move out of the cell Regulation of potassium metabolism a) Movement of K+ between intra- and extra-cellular fluid Move into the cell Insulin catecholamine ( βagonist↑, K+ inward) extracellular [K+] move out of the cell catecholamine (αagonist↑, K+ outward) acid-base status: H-K-ATPase osmotic pressure physical exercise b) Excretion of K+ by kidney (in distal convoluted tubule) aldosterone extracellular [K+] distal (tubular) flow rate acid-bace status Contex medulla Kidney glomerulus filter Initial urine Proximal convolute tubule medullaru loop reabsorption Intercalated cell Distal convoluted tubule collecting duct regulation I. maintains the stability of acid-base osmotic pressure II. influence protein and carbohydrates metabolisms - + + + + - - - III. control the tissue excitability The function of potassium hypokalemia Abnormally low potassium concentration in the serum, lesser than 3.5 mmol/L Why? K+ 3.5… intake? output ? distribution Can’t skin kidney gastrointedtinal tract in cell Kidney glomerulus filter throu