Abstract
Hyperkalemia is a potentially fatal complication requiring prompt diagnosis and management.
However, pseudohyperkalemia, defined as an artificial rise in serum potassium (Sk), is also an important diagnosis because management differs. Pseudohyperkalemia can
result from multiple factors, including excessive potassium leakage from cells of
the forearm during blood collection due to release from exercising the muscle during
fist clenching, while washout is prevented by tourniquet application, hemolysis, problems
with sample transport, preanalysis or contamination, cell damage and metabolic changes,
familial conditions that permit excessive potassium ion (K+) leak from erythrocytes after blood sampling, and leukocytosis or thrombocytosis.
In this review, we will discuss the major causes of pseudohyperkalemia, how to avoid
certain diagnostic pitfalls, and comment on the clinical importance of recognizing
these false readings. We will review three clinical cases seen in our nephrology and
hypertension clinic that illustrate some of these problems.
Keywords
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Article Info
Publication History
Published online: April 07, 2022
Footnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
Requests for reprints should be addressed to Negiin Pourafshar, MD, Assistant Professor of Medicine, Division of Nephrology and Hypertension, Medstar Georgetown University, Washington DC.
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