Acidosis directly up-regulates ammoniagenesis through various mechanisms. Hypokalemia also up-regulates ammoniagenesis, whereas hyperkalemia down-regulates it, likely because of the effects of basolateral H+/K+ exchange on intracellular pH. Angiotensin II also up-regulates ammoniagenesis by stimulating the NHE-3 exchanger, which increases NH4+ secretion. Meanwhile, several factors increase proton secretion in the collecting duct, as described in the section on titratable acids.
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