Hyperkalaemia

Causes

Appropriate Tests

Artefactual result including

  • Thrombocytosis
  • Leucocytosis (marked)

Spurious increase in serum potassium is common, especially if there is haemolysis during the collection or any delay in separation and/or refrigeration of blood.

See Table 1.

Another specimen should be collected if spurious hyperkalaemia is suspected.

A repeat specimen should be collected in lithium heparin, for plasma potassium.

Renal failure

 

Acidosis

Hyperkalaemia can occur in the presence of total body potassium deficiency, particularly if acidosis is present.

Adrenocortical insufficiency, especially

  • Addison's disease
  • Hypoaldosteronism

Particularly if there is associated renal impairment.

Drug-induced, especially

  • NSAIDs
  • Potassium sparing diuretics, including
    • Amiloride
    • Spironolactone
  • Potassium supplements
  • ACE inhibitors, especially,
    • Captopril

 

Cellular injury, especially

  • Severe burns
  • Crush injury
  • Acute severe haemolysis

 


See Rhabdomyolysis under Myoglobinuria.
See Haemoglobinuria.