Fig. 2.

Effect of hyperchloremic metabolic acidosis on circulating K⁺ level. In hyperchloremic metabolic acidosis some extracellular H⁺ shifts into the intracellular space. Since Cl^- remains largely in the extracellular fluid, a shift of K⁺ from the intracellular to the extracellular fluid occurs. No tendency towards hyperkalemia occurs in normochloremic metabolic acidosis, such as lactate acidosis or ketoacidosis, because organic anions enter the intracellular fluid