Regulation of extracellular potassium in hypothermia

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Abstract
Reduction of rectal temperature by ice packing in anesthetized dogs resulted in a fall in plasma potassium concentration in spite of the fall in arterial pH. Such a decrease in extracellular pH in normothermia would cause an increase in plasma K concentration. It was suggested that due to previously shown depression of renal acidification mechanisms in hypothermia, there occurred a K+ for Na+ exchange in the renal tubule with K+ being excreted instead of H+. It was expected that removal of renal function during hypothermia would allow the alteration in pH to cause an increase in extracellular K. Renal function was therefore removed by bilateral nephrectomy in five dogs and by ligation of both ureters in four dogs. Contrary to expectations, it was found that in the absence of renal function during hypothermia plasma K still fell markedly. No difference was found in the nephrectomized or ureter-tied dogs. It was proposed that in hypothermia, in the absence of renal function, some function of intracellular metabolism controlled extracellular K. Possibly intracellular pH decreased relatively more than did extracellular pH with a resultant movement of H+ out of the cell and K+ in. With renal function present in hypothermia, the influx of K into the cell seen in nephrectomized and ureter-tied dogs is reversed by the renal gradient which causes both a decrease in cellular and extracellular K.

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