What causes pseudohyperkalemia?

• A. Hemolysis after blood draws
• B. Renal failure
• C. Insulin deficiency
• D. Hyperosmolar hyperglycemic state

Answer: (A)

Pseudohyperkalemia is a falsely elevated potassium level caused by potassium leaking out of cells during or after the blood sample is taken, so the lab result looks high even though the body’s actual potassium is normal. The most common and classic cause is hemolysis after blood draws, where red blood cells rupture and release their potassium into the plasma. This artifact makes the test read higher than the true in-body potassium. True hyperkalemia, on the other hand, occurs because of real bodily potassium imbalance, as seen with renal failure (reduced excretion) or insulin deficiency and related states (which cause potassium to shift out of cells or accumulate). So the lab artifact from hemolysis best explains pseudohyperkalemia.