Investigating Elevated Potassium Values


One of the most frequently asked questions regarding phlebotomy is, why are the potassiums high? The answer involves a variety of factors, which can have a significant impact on the care of a patient. When an abnormally high value exists, it frequently sets off a train of investigations looking for such severe diseases as: renal failure; adrenocortical hypofunction; and diabetes. A falsely elevated potassium value (pseudohyperkalemia) discovered in a pre-surgical work-up can unnecessarily delay surgery and result in additional time in the hospital. Conversely, pseudohyperkalemia can elevate an abnormally low potassium, masking a real illness such as: adrenocortical hyperfunction or tumor; renal failure (potassium-losing phase); and metabolic alkalosis secondary to obstructive lung disease.  When potassium levels are falsely elevated by specimen-collection or -processing errors, patients can be subjected to medical mistakes with disastrous consequences.

Authors: Daniel M Baer, Dennis J Ernst, Susan I Willeford, Raymond Gambino
Keywords: hyperkalemia, hypokalemia, pseudohyperkalemia, fictitious hyperkalemia
DOI Number: none provided      Publication Year: 2006

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