From the Research
Coagulation and Serum Potassium Levels
- Coagulation can affect serum potassium levels, as evidenced by studies that have shown a correlation between thrombocytosis and elevated serum potassium levels 1, 2, 3, 4, 5.
- The release of potassium from platelets during coagulation can lead to spurious elevation of serum potassium levels, particularly in patients with thrombocytosis 1, 2, 3, 4, 5.
- This phenomenon is known as pseudohyperkalemia, and it can be defined as a rise in serum potassium concentration with concurrently normal plasma potassium concentration 3.
Factors Contributing to Pseudohyperkalemia
- Thrombocytosis is a major contributor to pseudohyperkalemia, as the release of potassium from platelet granules during coagulation can lead to elevated serum potassium levels 2, 3, 4, 5.
- Erythrocytosis can also contribute to pseudohyperkalemia, as the dilution of released potassium in smaller volumes of serum can lead to elevated serum potassium levels 3.
- The presence of activated platelets can also contribute to pseudohyperkalemia, as they have the capability of aggregating at a higher speed and releasing more potassium during degranulation 3.
Clinical Implications
- Pseudohyperkalemia can lead to inappropriate management of patients, as it may be misinterpreted as true hyperkalemia 5.
- Awareness of pseudohyperkalemia in disease conditions with increased platelet counts is essential to avoid potentially harmful treatment 5.
- Measuring potassium levels in plasma may be more accurate than in serum, especially in subjects with thrombocytosis 4.