Hyperkalemia Differential Diagnosis Algorithm

R/O Pseudo-hyperkalemia:

 • Possible Lab error! Alwavs Repeat Blood sample!

 • Leukocytosis, Thrombocytosis: cells lyse as sample is analyzed, releasing K+ into serum.

 • Excessive fist clenching + tourniquet while drawing blood (ischemia-induced RBC hemolysis)

 • RBC Hemolysis in the sample (rare)

*TTKG should be high (>7) - principal cells should be trying to excrete more K+ to reduce plasma [K+]



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