Relationship of renal ammonia production and potassium homeostasis

The renal production of ammonia is classically perceived as a regulatory system which responds to perturbations in the acid-base status of the organism [1–4]. A growing body of evidence suggests that ammonia production is also intimately related to potassium homeostasis, and that these two parameters may form the components of a feedback system with an important regulatory function [5–7]. It has been proposed that potassium homeostasis regulates renal ammonia production, which in turn influences both urinary potassium and hydrogen ion excretion [5–7]. The first section of this review will focus on the clinical and physiologic observations supporting an ammonia production-potassium relationship, and the second portion will consider the data currently available concerned with the biochemical mechanisms whereby potassium modulates renal ammoniagenesis.