Metabolic acidosis is associated with which electrolyte disturbance?

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In metabolic acidosis, excess hydrogen ions drive a shift of H+ into cells and K+ out of cells to help balance charge. This exchange raises the amount of potassium in the extracellular fluid, making hyperkalemia a common accompanying finding. The kidneys may also fail to excrete potassium adequately in acidosis, further increasing serum potassium. Clinically, this matters because hyperkalemia can cause dangerous ECG changes and arrhythmias, so potassium levels are closely monitored and guarded as acidosis is treated. By contrast, hypokalemia is more associated with metabolic alkalosis or conditions causing potassium loss, and hypernatremia or hypophosphatemia are not defining features of metabolic acidosis.