Background Hyperkalemia in association with metabolic acidosis that are out of proportion
to changes in glomerular filtration rate defines type 4 renal tubular acidosis (RTA), the most
common RTA observed, but the molecular mechanisms underlying the associated metabolic
acidosis are incompletely understood. We sought to determine whether hyperkalemia
directly causes metabolic acidosis and, if so, the mechanisms through which this occurs.
Methods We studied a genetic model of hyperkalemia that results from early distal …