Pseudohyperkalemia: Three Cases and a Review of Literature

Saleh-Anaraki, Kimia; Jain, Anjuli; Wilcox, Christopher S.; Pourafshar, Negiin

doi:10.1016/j.amjmed.2022.01.036

Cited by 4 publications

(4 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pseudohyperkalemia is among the frequently observed abnormalities following non-adherence to proper techniques. These include excessive fist clenching, prolonged tourniquet, use of too small needle size, forceful blood extraction, and vigorous sample mixing, leading to local tissue and cellular damage resulting in hyperkalemia [22]. Their impact on potassium is even more significant than sample contamination from the wrong draw order [23].…”

Section: Phlebotomy Techniquesmentioning

confidence: 99%

See 1 more Smart Citation

Preanalytical Errors in Clinical Laboratory Testing at a Glance: Source and Control Measures

Nordin,

Ab Rahim,

Wan Omar

et al. 2024

Cureus

View full text Add to dashboard Cite

The accuracy of diagnostic results in clinical laboratory testing is paramount for informed healthcare decisions and effective patient care. While the focus has traditionally been on the analytical phase, attention has shifted towards optimizing the preanalytical phase due to its significant contribution to total laboratory errors. This review highlights preanalytical errors, their sources, and control measures to improve the quality of laboratory testing. Blood sample quality is a critical concern, with factors such as hemolysis, lipemia, and icterus leading to erroneous results. Sources of preanalytical errors encompass inappropriate test requests, patient preparation lapses, and errors during sample collection, handling, and transportation. Mitigating these errors includes harmonization efforts, education and training programs, automated methods for sample quality assessment, and quality monitoring. Collaboration between laboratory personnel and healthcare professionals is crucial for implementing and sustaining these measures to enhance the accuracy and reliability of diagnostic results, ultimately improving patient care.

show abstract

Section: Phlebotomy Techniquesmentioning

confidence: 99%

“…The purpose is to reduce the carryover of additive contamination, which can lead to erroneous results [26,27]. EDTA contamination, for example, can cause spurious hyperkalemia and hypocalcemia secondary to the EDTA chelation effect [22,28]. In practice, tubes and additives are identified mainly by the color of the tube closures.…”

Section: Order Of Drawmentioning

confidence: 99%

Preanalytical Errors in Clinical Laboratory Testing at a Glance: Source and Control Measures

Nordin,

Ab Rahim,

Wan Omar

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“…While these conditions need to be thoroughly evaluated in all patients presenting with acute or chronic hyperkalemia, an important condition that should be ruled out is pseudohyperkalemia, which is a rise in potassium level due to excessive release of potassium. Pseudohyperkalemia can occur during or after blood collection and can be caused by hemolysis (e.g., by a faulty sample collection or fist clenching), leukocytosis or thrombocytosis [ 9 , 15 ]. While an extensive summary of all causes of hyperkalemia is beyond the scope of this review, a brief summary of common causes (including medications and the location of action) is noted in Table 1 .…”

Section: Causesmentioning

confidence: 99%

Hyperkalemia: Prevalence, Predictors and Emerging Treatments

Larivée

Michaud

et al. 2022

Cardiol Ther

View full text Add to dashboard Cite

It is well established that an elevated potassium level (hyperkalemia) is associated with a risk of adverse events including morbidity, mortality and healthcare system cost. Hyperkalemia is commonly encountered in many chronic conditions including kidney disease, diabetes and heart failure. Furthermore, hyperkalemia may result from the use of renin-angiotensin-aldosterone system inhibitors (RAASi), which are disease-modifying treatments for these conditions. Therefore, balancing the benefits of optimizing treatment with RAASi while mitigating hyperkalemia is crucial to ensure patients are optimally treated. In this review, we will briefly discuss the definition, causes, epidemiology and consequences of hyperkalemia. The majority of the review will be focused on management of hyperkalemia in the acute and chronic setting, emphasizing contemporary approaches and evolving data on the relevance of dietary restriction and the use of novel potassium binders.

show abstract

“…Pseudohyperkalemia can result from fist clenching during blood sample collection due to release of potassium from muscles, thrombocytosis, leukocytosis and erythrocytosis especially in context of hematological malignancies that render the abnormal blood cells fragile [4]. Other causes of pseudohyperkalemia may include increased tension due to tourniquet and mechanical lysis of red blood cells by inverting tubes too rigorously [5,6].…”

Section: Introductionmentioning

confidence: 99%

The Potential Role of Egfr in Differentiating Between True and Pseudohyperkalemia at a Tertiary Care Hospital

Haider,

Tumrani,

Sana

et al. 2023

Pak J Pathol

View full text Add to dashboard Cite

Objective: To determine the potential role of eGFR in differentiating between true and pseudohyperkalemia at a tertiary care hospital. Material and Methods: Cross-sectional study conducted in department of Chemical Pathology, Sheikh Zayed Hospital, Rahim Yar khan from January 1, 2022 to August 31, 2022. A total of 101 study subjects satisfying the inclusion criteria were included in study. Included specimen were analysed for serum creatinine level and estimated glomerular filtration rate (eGFR) was calculated by using chronic kidney disease-Epidemiology Collaboration (CKD-EPI) creatinine equation. Results: Of the total 101 study subjects, 59(58.4%) were male and 42(41.65%) were females. Mean age of study subjects was 45.28±12.265 years. Of the total 101 study samples, 75(74.3%) were classified as true hyperkalemia while 26(25.7%) were classified as pseudohyperkalemia with statistically significant difference of eGFR between two groups (P value: 0.00). Conclusion: Serum electrolytes are one of the most frequently requested diagnostic tests; thus, errors in these readings may alter the course of treatment for patients. As shown in our study that true hyperkalemia is very rare in patients with normal kidney function. So, estimated GFR can be taken as useful tool to differentiate between true and pseudohyperkalemia. Key Words: Pseudohyperkalemia, True hyperkalemia, Estimated GFR, CKD

show abstract

Pseudohyperkalemia: Three Cases and a Review of Literature

Cited by 4 publications

References 35 publications

Preanalytical Errors in Clinical Laboratory Testing at a Glance: Source and Control Measures

Preanalytical Errors in Clinical Laboratory Testing at a Glance: Source and Control Measures

Hyperkalemia: Prevalence, Predictors and Emerging Treatments

The Potential Role of Egfr in Differentiating Between True and Pseudohyperkalemia at a Tertiary Care Hospital

Contact Info

Product

Resources

About