Ion-Selective Electrodes for Measuring Potassium in Erythrocytes: a Model for Clinical Interpretation of the Results (a Pilot Study).

The aim of the investigation is to study the concentration of potassium in erythrocytes using the proposed method, potassium interconnection with other electrolyte and acid-base parameters of blood plasma, and to create the basis for clinical interpretation of the results.

Materials and methods: Potassium content in erythrocytes was measured using a blood gas analyzer with ion-selective electrodes in parallel with the laboratory procedure. Patients from intensive care units were randomly selected for the study.

Results: No correlations of potassium with other plasma parameters have been found, however its buffer dependence on chlorine in plasma has been established. Minimal value of potassium concentration in erythrocytes (for 356 measurements) was 68.2 mmol/L, maximal - 210.2 mmol/L.Following the logic of the acid-base status, a nomogram for clinical interpretation of intracellular potassium homeostasis has been developed. The low values are mainly connected with the deficit of potassium which is impossible to determine in blood plasma (e.g. in severe metabolic alkalosis or diuretic therapy). The elevated concentration of potassium in erythrocytes is caused by eryptosis: released potassium is absorbed by normal erythrocytes (protection from hyperkalaemia). So, the increased concentration of potassium indicates directly the presence of eryptosis triggers, i.e. inflammatory mediators, oxidative stress, and others, for example in sepsis. The results of the study have shown that measurement of potassium concentration in erythrocytes with the help of ion-selective electrodes is an effective method of monitoring its intracellular homeostasis. Potassium in erythrocytes is an independent biological marker which can provide clinically relevant information.