Bicarbonate in the kidneys and elevated K

[Lanie_82NS]

Hey folks! I'm reaching far into my brain and if I remember correctly bicarbonate is secrets by the kidneys which helps buffer the amount of k that is excreted. Anyhow my theory is for the compensatory stage of shock and decrease in uop that is why the k levels are elevated because of the metabolic acidosis from the bicarbonate. Am I on the right track? Thanks in advance!

[NICUismylife, ADN, BSN, RN]

#1: bicarb is not secreted by the kidneys, it is reabsorbed by the kidneys in the tubules, is that what you were referring to?

#2: Bicarb is a base, so an excess of bicarb would cause alkalosis not acidosis

It sounds like your real question is why do K levels rise when a patient is in shock?

You've already mentioned that urine output decreases when a patient is in shock (for additional challenge, research further and understand why this happens). So if K is excreted in the urine, what happens if the patient isn't urinating? Also, you didn't mention the cause of the shock. If it is due to any type of trauma that would cause cell lysis, what is the main cation inside the cell that would be released upon cell lysis?

I think you tried to over-complicate this a little too much, which is actually really common among students, or so my instructors always say.

[Lanie_82NS]

Lol I probably did and thanks for clearing that up