Stability of potassium, calcium and phosphorus electrolytes in three different tubes in patients with essential thrombocytosis

Scand J Clin Lab Invest. 2023 Dec;83(8):582-590. doi: 10.1080/00365513.2023.2289162. Epub 2024 Jan 24.

Abstract

Proper blood collection and timely analysis are vital steps for reliable results. This study aims to compare potassium(K), calcium(Ca), and phosphorus(P) concentrations in serum separator tube (SST), lithium heparin tube without gel (LiH), and lithium heparin tube with a barrier (Barricor)tubes in essential thrombocytosis(ET) patients. Additionally, we assessed short-term stability of these analytes at room temperature. K, Ca and P concentrations of blood taken from 40 ET patients into SST, LiH and Barricor tubes were measured at 0, 2, 4 and 8 h. We calculated the percentage difference and defined the maximum permissible difference (MPD) using the Biological Variation Database. Intertube comparisons were conducted using Passing-Bablok regression and Bland-Altman analysis. Comparing SST to LiH, the percentage difference values for all tests exceeded the MPD. When comparing Barricor to LiH, K and Ca tests were above MPD, except for P. At the 8th hour, LiH showed clinically significant changes in all three electrolytes. Barricor exhibited stability for K, Ca, and P for up to 8 h, with only Ca levels borderline higher than the MPD. Our study reveals clinically significant alterations in K, Ca, and P concentrations in SST compared to LiH tubes, and in K and Ca concentrations in Barricor compared to LiH tubes. While K, Ca and P concentrations were stable for up to 4 h at room temperature in all tube types tested, significant changes were observed in all electrolytes at 8 h in the LiH tube.

Keywords: Electrolytes; hypercalcemia; hyperkalemia; hyperphosphatemia; thrombocytosis.

MeSH terms

  • Blood Specimen Collection / methods
  • Calcium
  • Electrolytes
  • Heparin
  • Humans
  • Lithium
  • Phosphorus
  • Potassium*
  • Thrombocytosis*

Substances

  • Potassium
  • Calcium
  • Phosphorus
  • Lithium
  • Heparin
  • Electrolytes