Interestingly, one of the studies I discussed in a previous post (ref. 3; 12/05/16), which examined records of nearly 40,000 hospitalized patients, did find an increased death risk for hypokalemia. Thus, being a patient in a hospital and having a low potassium constitutes a risk compared to adults who are not hospitalized.
Based on all of these studies, physicians are correct to worry when they receive a result of increased potassium. That is why many patients are sent to the nearest ER for further evaluation of an elevated potassium result. Which is also why medical labs must ensure that the potassium results they turn out are accurate and reliable. Unfortunately, lab analysis of potassium is fraught with errors. Potassium analysis has many potential pitfalls because of the biology of potassium: almost all potassium in the blood is stored in red cells, so any breakage of red cells releases potassium into serum where it will be measured in the lab. This breakage of red cells (hemolysis) is a problem concerning which labs must be eternally vigilant. Most red cell breakage is caused by traumatic blood draws for obtaining blood specimens for analysis. Another issue with potassium is that storage of blood samples in the refrigerator will increase potassium in the serum where it will be detected because the enzyme that keeps potassium inside red cells likes at least room temperature to keep working properly and is very cold sensitive, in other words, the enzyme shuts down under refrigeration and potassium begins to leak out into the serum.
You can read about these aspects of potassium analysis and much, much more in my eBook Blood Trails: Follow your medical lab work from beginning to end with everything that can go wrong in between, plus how doctors misunderstand and misuse blood tests (available at amazon.com as both print-on-demand as well as eBook).
1. Chen Y et al. Serum Potassium, Mortality, and Kidney Outcomes in the Atherosclerosis Risk in Communities Study. Mayo Clin Proc 91: 1403–1412, 2016
2. Loprinzi PD Hall ME. Effect of Serum Potassium on All-Cause Mortality in the General US Population. Mayo Clin Proc 92: 320, 2017.
3. Solinger AB, Rothman SI. Risks of mortality associated with common laboratory tests: a novel, simple and meaningful way to set decision limits from data available in the electronic medical record. Clin Chem Lab Med DOI 10.1515/cclm-2013-0167.