Elevated serum potassium values: the role of preanalytic variables

Area of Science:

• Clinical Chemistry
• Laboratory Medicine
• Patient Safety

Background:

• Potassium is a critical analyte for maintaining body homeostasis.
• Inaccurate potassium results due to laboratory errors pose significant risks to patient safety.
• Pseudohyperkalemia, a spurious increase in serum potassium, leads to unnecessary healthcare costs and potential treatment delays.

Purpose of the Study:

• To identify variables causing pseudohyperkalemia.
• To understand the mechanisms behind these spurious increases in serum potassium.
• To define corrective actions to mitigate pseudohyperkalemia.

Main Methods:

• Review of literature focusing on preanalytic factors affecting serum potassium.
• Analysis of patient-specific variables and specimen handling processes.
• Discussion of mechanisms leading to falsely elevated potassium levels.

Main Results:

• Most pseudohyperkalemia cases stem from issues in the preanalytic phase of testing.
• Patient-specific factors and specimen acquisition, processing, handling, and transport are key contributors.
• Understanding these variables is crucial for accurate potassium testing.

Conclusions:

• Identifying and addressing preanalytic variables is essential to prevent pseudohyperkalemia.
• Minimizing spurious elevations in serum potassium improves patient safety and optimizes healthcare resource utilization.
• Corrective actions targeting the preanalytic phase can significantly reduce the incidence of pseudohyperkalemia.