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Hyperchloremia is an electrolyte disturbance in which there is an elevated level of chloride ions in the blood. [1] The normal serum range for chloride is 96 to 106 mEq/L, [2] therefore chloride levels at or above 110 mEq/L usually indicate kidney dysfunction as it is a regulator of chloride concentration. [3]
The levels of chloride in the blood can help determine if there are underlying metabolic disorders. [20] Generally, chloride has an inverse relationship with bicarbonate, an electrolyte that indicates acid-base status. [20] Overall, treatment of chloride imbalances involve addressing the underlying cause rather than supplementing or avoiding ...
Ingestion of ammonium chloride, hydrochloric acid, or other acidifying salts; The treatment and recovery phases of diabetic ketoacidosis; Volume resuscitation with 0.9% normal saline provides a chloride load, so that infusing more than 3–4L can cause acidosis; Hyperalimentation (i.e., total parenteral nutrition)
A diagnostic test may use a chloridometer to determine the serum chloride level. The North American Dietary Reference Intake recommends a daily intake of between 2300 and 3600 mg/day for 25-year-old males. Reference ranges for blood tests, showing blood content of chloride at far right in the spectrum.
This is to maintain the plasma's electrical balance, as the chloride anions have been extracted. The bicarbonate content causes the venous blood leaving the stomach to be more alkaline than the arterial blood delivered to it. The alkaline tide is neutralised by a secretion of H + into the blood during HCO 3 − secretion in the pancreas. [2]
When salt is ingested, it is dissolved in the blood as two separate ions – Na + and Cl −. The water potential in blood will decrease due to the increased solutes, and blood osmotic pressure will increase. While the kidney reacts to excrete excess sodium and chloride in the body, water retention causes blood pressure to increase. [10]
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Diagnosis of contraction alkalosis is made by correlating laboratory data with clinical history and examination. Metabolic alkalosis in the presence of decreased effective circulatory volume, loop diuretic use, or other causes of intravascular depletion such as profound diarrhea should raise suspicion for contraction alkalosis as a likely etiology in the absence of other causes.