Hemolysis interference on clinical chemistry tests analyzed on DxC 700 AU (Beckman Coulter®) and kaliemia rendering algorithm 2022

Emeline Sanandedji, and Julien André, and Alexi Lienard, and Caroline Hentgen, and Alain Barrans

The influence of hemolysis was evaluated for 26 clinical chemistry parameters on DxC 700AU (Beckman Coulter®). Ten sample pools were prepared and separated into six aliquots. These aliquots were overloaded with hemolysis in increasing amounts to reach levels equivalent to the maximum hemolysis thresholds H1 (+), H2 (++), H3 (+++) and H4 (++++). Each aliquot is compared to its reference aliquot (not hemolyzed) and a ratio is calculated for each parameter. We proposed that there was a significant difference if, for a given analyte and threshold, more than 20% of the ratios are above the total acceptable limit variability. A significant difference was found for TGP, TGO, cholesterol, creatine kinase (CPK), lactate deshydrogenase (LDH), phosphorus and potassium at H1 (+), chlorine, iron, γ-glutamyltransferase (GGT), and magnesium at H2 (++), amylase and alkaline phosphatase (PAL) at H3 (++++), and prealbumin at H4 (++++). No interference was found until H4 included for uric acid, calcium, creatinine, lipase, glucose, HDL-cholesterol, triglycerides, urea, sodium and immunoglobulins A, G and M. The overestimation of kalemia was calculated as a function of hemolysis, ranging from 0.28 mM +/–0.047 (upper H1 threshold) to 1.37 mM +/–0.126 (upper H4 threshold). Its estimation makes it possible to propose a result rendering algorithm of kalemia according to the hemolysis index. Evaluation of the automates hemolysis indexes is highly recommended for each laboratory. It can allow for some critical parameters the establishment of a decision tree facilitating the result rendering, after clinicobiological consultation.

UI MeSH Term Description Entries
D002784 Cholesterol The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. Epicholesterol
D006403 Hematologic Tests Tests used in the analysis of the hemic system. Blood Tests,Hematologic Test,Hematological Tests,Test, Hematologic,Tests, Hematologic,Blood Test,Hematological Test,Test, Blood,Test, Hematological,Tests, Blood,Tests, Hematological
D006461 Hemolysis The destruction of ERYTHROCYTES by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. Haemolysis,Extravascular Hemolysis,Intravascular Hemolysis,Extravascular Hemolyses,Haemolyses,Hemolyses, Extravascular,Hemolyses, Intravascular,Hemolysis, Extravascular,Hemolysis, Intravascular,Intravascular Hemolyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000465 Algorithms A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. Algorithm
D019963 Clinical Chemistry Tests Laboratory tests demonstrating the presence of physiologically significant substances in the blood, urine, tissue, and body fluids with application to the diagnosis or therapy of disease. Chemistry Tests, Clinical,Chemistry Test, Clinical,Clinical Chemistry Test,Test, Clinical Chemistry,Tests, Clinical Chemistry

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