Pseudohyperkalemia on Maintenance Hemodialysis / 대한신장학회잡지

ABSTRACT

BACKGROUND: The serum to plasma potassium [K] difference in patients(n=42) on maintenance hemodialysis more than one year was analyzed to evaluate the prevalence of pseudohyperkalemia among them. METHODS: In all 42 hemodialysis patients, the following predialysis serum and plasma K concentration frequencies were as followed serum K-normal (3.5-5.5 mEq/L) 24, high(>or=5.6 mEq/L) 18, low(plasma K-normal(3.1-5.1 mEq/L) 29, high 11, low 2 each. Nine out of 18 patients with high serum K revealed normokalemia in plasma K and 1 patient revealed even hypokalemia in plasma K(3.0 mEq/L).

RESULTS:

The difference between serum K(mean+/-SE, 5.4+/-0.14 mEq/L) and plasma K(4.9+/-0.13 mEq/ L) was statistically significant with the range from -0.3 to 1.6 mEq/L(mean, 0.72+/-0.3 mEq/L, p<0.05). Also similar results were seen in 29 hemodialysis patients, who were simultaneously measurement of serum and plasma K had 3 times of blood collection. In contrast, its difference in normal healthy 12 subjects measured simultaneously with hemodialysis patients ranged only from -0.1 to 0.6 mEq/L(mean, 0.25+/-0.2 mEq/L). However, platelets or white blood counts were not different significantly between hemodialysis patients and healthy subjects. Furthermore, no correlation between the values of serum minus plasma K concentrations and platelets or white blood cell counts in 2 groups.

CONCLUSION:

when unexpected high serum K are found on maintenance hemodialysis patients in the presence or absence of leukocytosis and/or thromocytosis, In the present study recommend routinely measuring simultaneous plasma K to verify the results being valid or not, in order to avoid unnecessary treatments and its accompaning side effects.