Misleading Hyponatremia Due to Hyperlipemia: A Method-Dependent Error

Brief Reports1 December 1981Misleading Hyponatremia Due to Hyperlipemia: A Method-Dependent ErrorJACK H. LADENSON, Ph.D., FRED S. APPLE, Ph.D., DAVID D. KOCH, Ph.D.JACK H. LADENSON, Ph.D., FRED S. APPLE, Ph.D., DAVID D. KOCH, Ph.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-95-6-707 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSerum from patients with hyperlipemia has been clearly shown to have low sodium values when analyzed by flame photometry (1-10). This artifactually low sodium value is due to a decrease in the percentage of water (water content) in serum or plasma. This decrease in water content leads to less sodium in a given volume aliquot of the sample taken for analysis even though the "concentration" of sodium in the water phase may be unaltered. Methods for measuring sodium in serum include the traditional technique of flame photometry or the more recent and increasingly used technique of potentiometry using a sodium...References1. ALBRINKHALDMANPETERS MPEJ. The displacement of serum water by the lipids of hyperlipemic serum. J Clin Invest. 1955;34:1483-8. CrossrefMedlineGoogle Scholar2. WAUGH W. Utility of expressing serum sodium per unit of water in assessing hyponatremia. Metabolism. 1969;18:706-12. CrossrefMedlineGoogle Scholar3. BELLHILTONWALKER JPG. Severe hyponatremia in hyperlipaemic diabetic ketosis. Br Med J. 1972;4:709-10. CrossrefMedlineGoogle Scholar4. STEFFESFREIER ME. A simple and precise method of determining true sodium, potassium, and chloride concentrations in hyperlipemia. J Lab Clin Med. 1976;88:683-8. MedlineGoogle Scholar5. LADENSON J. Direct potentiometric analysis of sodium and potassium in human plasma: evidence for electrolyte interaction with a nonprotein, protein-associated substance(s). J Lab Clin Med. 1977;90:654-65. MedlineGoogle Scholar6. DUNNESHENKINIMRIE MAC. Misleading hyponatremia in acute pancreatitis with hyperlipaemia. Lancet. 1979;1:211. Letter. CrossrefMedlineGoogle Scholar7. BURNGILL JG. Pseudonormonatraemia. Br Med J. 1979;2:1110-1. CrossrefMedlineGoogle Scholar8. FRIERSTEERBAIRDBLOOMFIELD BCJS. Misleading plasma electrolytes in diabetic children with severe hyperlipidaemia. Arch Dis Childhood. 1980;55:771-5. CrossrefMedlineGoogle Scholar9. Dangerous pseudohyponatraemia. Lancet. 1980;2:1121. Editorial. Google Scholar10. FORRESTSHENKIN AA. Dangerous Pseudohyponatraemia. Lancet. 1980;2:1256. Letter. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Washington University School of Medicine St. Louis, Missouri PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byInterference in Ion-Selective Electrodes Due to Proteins and LipidsWhich laboratory technique is used for the blood sodium analysis in clinical research? A systematic reviewDiscrepancies in Electrolyte Measurements by Direct and Indirect Ion Selective Electrodes due to Interferences by Proteins and LipidsRelationship between Plasma Triglyceride Level and Severity of Hypertriglyceridemic PancreatitisHyponatremia and HypernatremiaApproach to the Patient With a Negative Anion GapHyponatremiaDisagreement between ion selective electrode direct and indirect sodium measurements: Estimation of the problem in a tertiary referral hospitalDisorders of Sodium and WaterIon Selective Electrodes (ISEs) and interferences—A reviewHyponatremia and HypernatremiaHyponatremiaDisorders of Sodium and Water: Hypernatremia and HyponatremiaPseudohyponatremia: Does It Matter in Current Clinical Practice?Hyponatremia in Critically Ill PatientsDisorders of fluid and electrolytesDecreased water: increased solids: distorted serum concentrationsElectrolyte DisordersHyponatraemiaRecommendations for Measurement of and Conventions for Reporting Sodium and Potassium by Ion-Selective Electrodes in Undiluted Serum, Plasma or Whole BloodTransferability of results obtained for sodium, potassium and chloride ions with different analysersHyponatremiaMisleading Acute Hypercalcemia Due to Hyperlipidemia: a Method Dependent ErrorHYPONATREMIA AND HYPERNATREMIAHyponatremic emergenciesSpurious laboratory values in diabetic ketoacidosis and hyperlipidemiaCalculations of "predicted" serum sodium concentration in diabetic ketoacidosis10 HyponatraemiaPseudohyponatremia: A reappraisalHyponatremiaThe Pediatric Acute Care LaboratoryAnion gap-bicarbonate relation in diabetic ketoacidosisEvaluation of the direct potentiometric method for serum chloride determination—comparison with the most commonly employed methodologiesA Comparison of the Beckman System E4A Electrolyte Analyzer, the Nova 5+5 Automated Electrolyte Analyzer and Other Methods of Electrolyte AnalysisA Comparison of the Measurement of Sodium and Potassium by Flame Photometry and Ion-Selective ElectrodePseudohyponatremiaThe turbid specimen as an analytical medium: hemoglobin determination as a modelMessung des Säure-Basen-Status, Elektrolytbestimmung und Einsatz ionenselektiver Elektroden für die PatientenüberwachungSerum OsmolalitySpurious Hyperchloremia and Decreased Anion Gap in HyperlipidemiaMARK L. GRABER, M.D., RICHARD J. QUIGG, M.D., WILLIAM E. STEMPSEY, M.D., STEPHEN WEIS, D.O.Normal electrolyte and protein content in milk from mothers with cystic fibrosis: An explanation for the initial report of elevated milk sodium concentrationTest and teach Number Forty—two Part 2 Multiple Biochemical Analysis-Number Three 1 December 1981Volume 95, Issue 6Page: 707-708KeywordsAttentionBlood plasmaClinical chemistryFellowshipsHyperlipidemiaHyponatremiaResearch laboratoriesSodium Issue Published: 1 December 1981 PDF downloadLoading ...