Background: A multi-centre observational study investigating the prevalence of spurious hyperkalaemia due to potassium ethylenediaminetetraacetic acid (kEDTA) contamination.
Methods: Serum EDTA was measured in anonymised serum samples with a serum potassium > 6.0 mmol/L collected over a one month period in five different hospital laboratories. Two of the participating laboratories routinely screen all hyperkalaemic samples for EDTA contamination.
Results: EDTA contamination was present in 4.1% (range 1.2%-6.7%) of hyperkalaemic samples. In three laboratories, without routine EDTA screening, 50% "EDTA contaminated" were identified by laboratory staff, the remaining 50% samples were undetected and reported as genuine hyperkalaemia. In these laboratories, EDTA was not measurable in 2 samples reported as "EDTA contaminated".
Conclusions: Spurious hyperkalaemia due to kEDTA contamination is relatively common. Education regarding correct blood collection technique offers the best strategy in preventing EDTA sample contamination. Gross kEDTA contamination is easily identified by laboratory staff in samples with marked unexpected hyperkalaemia and hypocalcaemia. Spurious hyperkalaemia due to modest kEDTA contamination may only be confidently detected by measurement of serum EDTA.
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J Clin Pathol
September 2024
Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
To assess if ambient temperature-related effects on serum potassium levels impact clinical decision-making. This study is an ecological time series consisiting of 1 218 453 adult patients with at least one ACE inhibitor (ACEI) prescription who participate in a large UK primary care dataset.Descriptive statistics and a quasi-Poisson regression model using time series data at regular time intervals (monthly) were undertaken to examine the association between potassium measurements and ACEI/potassium supplement prescriptions.
View Article and Find Full Text PDFCureus
March 2022
Hematology and Medical Oncology, University of Florida College of Medicine, Jacksonville, USA.
Hyperkalemia is a common electrolyte disorder with potentially life-threatening consequences, including cardiac dysrhythmias. Pseudohyperkalemia must always be ruled out before implementing treatment for true hyperkalemia. Here, we present a case of a 63-year-old male with chronic lymphocytic leukemia (CLL) with a white blood cell count greater than 200 thousand/mm and persistently high serum potassium concentration as high as 8.
View Article and Find Full Text PDFAdv Lab Med
June 2022
Clinical Laboratory Department, Hospital Universitario La Paz, Madrid, Spain.
Point-of-care-testing (POCT) facilitates rapid availability of results that allows prompt clinical decision making. These results must be reliable and the whole process must not compromise its quality. Blood gas analyzers are one of the most used methods for POCT tests in Emergency Departments (ED) and in critical patients.
View Article and Find Full Text PDFClin Biochem
April 2020
Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States. Electronic address:
Objectives: Investigate concomitant and spurious high potassium and low sodium results in heparinized plasma.
Methods: Potassium and sodium values were measured from heparinized plasma and serum in a patient with B-cell non-Hodgkin lymphoma using both an automated chemistry analyzer (indirect ion selective electrode) and blood gas analyzer (direct ion selective electrode).
Results: Potassium levels were significantly increased while sodium levels were significantly decreased in heparinized plasma compared to serum on several occasions.
J Appl Lab Med
May 2019
Department of Blood Sciences, New Cross Hospital, Wolverhampton, UK.
Background: Potassium EDTA (kEDTA) contamination of serum samples is common, causing spurious hyperkalemia, hypozincemia, and hypocalcemia that if unrecognized may adversely affect patient care. Gross kEDTA contamination is easy to detect, but identification of spurious electrolytes due to small amounts of contamination requires measurement of serum EDTA. We validated an EDTA assay on the Abbott Architect and reassessed its value in identifying kEDTA contamination and in studying mechanisms for contamination.
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