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Serum potassium concentrations:
There is no strict correlation between the serum potassium concentration and total body potassium stores. In chronic hypokalaemia, a potassium deficit of 200 to 400 mmol (200 to 400 mEq) is required to lower the serum potassium concentration by 1 mmol/L (1 mEq/L). These estimates are good provided there is no concurrent acid-base abnormality (e.g., for diabetic ketoacidosis or severe non-ketotic hyperglycaemia).
In diabetic ketoacidosis patients may have a normal or even elevated serum potassium concentration at presentation, despite having a marked potassium deficit due to urinary and GI losses.
Spurious hypokalaemia can occur when blood with a high WBC count is left at room temperature due to extraction of potassium by the WBCs. It is therefore important to consider repeating the test for confirmation.
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