Serum Potassium Is Unreliable as an Estimate of in Vivo Plasma Potassium

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Abstract
The in vitro release of potassium from cells and platelets during blood clotting [particularly in patients with blood dyscrasias(1)(2)] increases serum potassium, on average, by 0.4 mmol/L (3). This difference is considered to be independent of collection tube type (4). Following a change in the supplier of collection tubes, however, we observed an increase in the frequency of pseudohyperkalemia, which prompted a formal evaluation of the serum-plasma difference and the effect of different tube types.

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