Root cause analysis of pseudohyperkalemia in a patient with focal segmental glomerulosclerosis: A case report

Abstract

Pseudohyperkalemia, also known as factitious or spurious hyperkalemia, is predominantly due to hemolysis during the collection process of the specimen. Pseudohyperkalemia is a condition in which the falsely elevated potassium can cause significant clinical dilemma as patients may be given unnecessary and harmful treatment for hyperkalemia. In addition, pseudohyperkalemia can also mask hypokalemia resulting in patients potentially not receiving adequate potassium replacement. Thus, it is pivotal for clinicians and laboratory personnel to have a high index of suspicion for this condition in order for the patient to receive appropriate treatment. We present a case of pseudohyperkalemia without obvious hemolysis due to the use of a 23-gauge needle blood draw in a patient with stage IV chronic kidney disease from focal segmental glomerulosclerosis.