Low Potassium or Low Chloride as Causes of Metabolic Alkalosis -------------------------------------------------------------- LOW POTASSIUM may cause metabolic alkalosis by: þ causing obligatory H+ excretion, instead of K+ excretion, in exchange for Na+); þ also, K+ shifts out of cells, and H+ shifts into cells, causing alkalosis and  HCO3-. LOW CHLORIDE causes obligatory excretion of K+ and H+, and therefore retention of HCO3-, to reabsorb Na+ and therefore to maintain volume.