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Dear Helen: Does “DISE” refer to direct potentiometry, such as one might have available on a whole blood analyzer? If so, I’m curious, what would lead you to suspect that direct potentiometry might produce a more accurate (lower) potassium in patients with no clinical suspicion of hyperkalemia? Hyperproteinemia or hyperlipidemia would produce falsely low potassium measurements using indirect potentiometry, and you would expect direct potentiometric measurement of electrolytes to produce higher results. I’d also be interested in how often you obtain significantly different results on repeat measurement of potassium by the same method, but on another instrument. Kind regards, Roger Roger L. Bertholf, PhD Medical Director of Clinical Chemistry Houston Methodist Hospital Professor of Clinical Pathology and Laboratory Medicine Weill Cornell Medicine From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of JERINA, Helen (UNIVERSITY HOSPITALS OF LEICESTER NHS TRUST) Sent: Monday, October 22, 2018 7:07 AM To: [log in to unmask] Subject: Potassium (again!) Hello Mailbase, I know potassium is a favourite topic of conversation here, but I couldn't find anything substantial to answer my questions in the archives (although I would fully accept that that may be down to my inability to search them correctly!). What I'd like to know is: * Do you re-run high potassiums and, if you do, is this by the same method or an alternative (e.g. re-check by DISE)? * What do you do with results where you suspect an artefactual cause? Do you take them out or do you report them with a comment? Here in Leicester, our policy is to re-analyse all potassium results >6.0 mmol/L where there is no obvious explanation (e.g. poor renal function or haemolysis). As we don't have DISE available in the lab we re-run by the same method but on an alternative analyser. We report all results, adding a comment where appropriate and always ask for a repeat if artefactual increase is suspected. We are reviewing our policy and there has been some discussion as to whether repeating the analysis adds any value. It would be great to hear what other labs do and I'm happy to share/collate any responses. Best wishes, Helen Helen Jerina PhD Senior Clinical Scientist Department of Chemical Pathology Level 4 Sandringham Building Leicester Royal Infirmary Leicester LE1 5WW ******************************************************************************************************************** This message may contain confidential information. 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