Under normal circumstances, delivery of Na+ to the distal nephron is inversely associated with serum aldosterone levels. Under normal circumstances, delivery.

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Under normal circumstances, delivery of Na+ to the distal nephron is inversely associated with serum aldosterone levels. Under normal circumstances, delivery of Na+to the distal nephron is inversely associated with serum aldosterone levels. For this reason, renal K+ excretion is kept independent of changes in extracellular fluid volume. Hypokalemia caused by renal K+ wasting can be explained by pathophysiologic changes that lead to coupling of increased distal Na+ delivery and aldosterone or aldosterone-like effects. When approaching the hypokalemia caused by renal K+ wasting, one must determine whether the primary disorder is an increase in mineralocorticoid activity or an increase in distal Na+ delivery. EABV, effective arterial blood volume. Biff F. Palmer CJASN 2015;10:1050-1060 ©2015 by American Society of Nephrology