Spurious hyperkalaemia due to EDTA contamination: common and not always easy to identify

This version was published on 1 November 2008

Ann Clin Biochem 2008;45:601-603
doi:10.1258/acb.2008.007241
© 2008 Association for Clinical Biochemistry

 

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Michael P Cornes1,
Clare Ford1 and
Rousseau Gama1,2


1 Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands WV10 0QP;
2 Research Institute, Healthcare Sciences, Wolverhampton University, Wolverhampton, West Midlands, UK


Corresponding author: Mr Michael Cornes. Email: cornesmp{at}aol.com


Background: To study the detection and prevalence of spurious hyperkalaemiadue to potassium ethylenediaminetetra-acetic acid (kEDTA) contamination.

Methods: In a one-month prospective study, serum EDTA, zinc, calcium, magnesium concentrations and alkaline phosphatase activity were measured in samples with serum potassium ≥6.0 mmol/L.

Results: Twenty-eight out of 117 hyperkalaemic samples were contaminatedwith EDTA. Only serum zinc values below the reference rangehad 100% sensitivity for indicating EDTA contamination, buteven at an optimal specificity of 89% at least 12 potentiallygenuine hyperkalaemic samples would be rejected.

Conclusion: Spurious hyperkalaemia due to kEDTA contamination is common.Gross kEDTA contamination is obvious by marked unexpected hyperkalaemia,hypocalcaemia, hypomagnesaemia and hypozincaemia. Spurious hyperkalaemiadue to low concentrations of kEDTA contamination can only beconfidently detected by measurement of serum EDTA.


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