Direct-measurement ion-selective electrodes: analytical error in hyponatremia.

Using two commercial direct ion-selective-electrode sodium and potassium analyzers, we found lower sodium values in cases of hyponatremia as compared with those by flame emission spectrophotometry or indirect ion-selective-electrode analyzers. It is shown that these errors can be eliminated by modifying the calibrant, and that there is a requirement for internationally agreed-upon reference standards for use by manufacturers and laboratory personnel to assess analytical performance of these analyzers.