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Chloride is an electrolyte. When combined with sodium it is mostly found in nature as “salt.” Chloride is important in maintaining the normal acid-base balance of the body and, along with sodium, in keeping normal levels of water in the body. Chloride generally increases or decreases in direct relationship to sodium, but may change without any change in sodium when there are problems with too much acid or base in your body. Chloride is taken into the body through food. Most of the chloride is absorbed by the gastrointestinal tract, and the excess is excreted in the urine. The normal blood concentration remains steady, with a slight drop after meals (because the stomach produces hydrochloric acid after eating, using chloride from blood).

About

Chloride is the major anion in the extracellular water space; its physiological significance is in maintaining proper body water distribution, osmotic pressure, and normal anion-cation balance in the extracellular fluid compartment.


Chloride is increased in dehydration, renal tubular acidosis (hyperchloremia metabolic acidosis), acute renal failure, metabolic acidosis associated with prolonged diarrhoea and loss of sodium bicarbonate, diabetes insipidus, adrenocortical hyperfunction, salicylate intoxication, and with an excessive infusion of isotonic saline or extremely high dietary intake of salt. Hyperchloremia acidosis may be a sign of severe renal tubular pathology.


Chloride is decreased in overhydration, chronic respiratory acidosis, salt-losing nephritis, metabolic alkalosis, congestive heart failure, Addisonian crisis, certain types of metabolic acidosis, persistent gastric secretion and prolonged vomiting, aldosteronism, bromide intoxication, syndrome of inappropriate antidiuretic hormone secretion, and conditions associated with an expansion of extracellular fluid volume.

Preparation

No test preparation is needed.

Indications

A blood chloride test may be requested to help evaluate kidney function and acid-base status. It may also be requested if you are in hospital and receiving intravenous (IV) fluids. If your sodium measurement is abnormal, the doctor may look at whether the chloride measurement changes in the same way. This may help the doctor to work out if there is also a problem with acid or base and may help guide treatment.

Interpretation

A severe elevation or loss of this electrolyte can indicate a serious fluid and electrolyte imbalance. The type of medical treatment depends on the cause of the problem.


Increased levels of chloride (called hyperchloraemia) usually indicate dehydration, but can also occur with any other problem that causes high blood sodium. Hyperchloraemia also occurs when too much alkaline fluid is lost from the body (producing metabolic acidosis), or when a person hyperventilates (causing respiratory alkalosis).


Decreased levels of chloride (called hypochloraemia) occur with any disorder that causes low blood sodium. Hypochloraemia also occurs with prolonged vomiting or gastric suction, chronic diarrhoea, emphysema, or other chronic lung diseases (causing respiratory acidosis), and with loss of acid from the body (called metabolic alkalosis).

Disclaimer

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

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