Hyperchloremia is an electrolyte disturbance

Electrolyte disturbance

Electrolytes play a vital role in maintaining homeostasis within the body. They help to regulate myocardial and neurological function, fluid balance, oxygen delivery, acid-base balance and much more. Electrolyte imbalances can develop by the following mechanisms: excessive ingestion; diminished...

 in which there is an abnormally elevated level of the chloride

Chloride

The chloride ion is formed when the element chlorine, a halogen, picks up one electron to form an anion Cl−. The salts of hydrochloric acid HCl contain chloride ions and can also be called chlorides. The chloride ion, and its salts such as sodium chloride, are very soluble in water...

 ion in the blood

Blood

Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....

. The normal serum range for chloride is 97 to 107 mEq/L

Equivalent (chemistry)

The equivalent , sometimes termed the molar equivalent, is a unit of amount of substance used in chemistry and the biological sciences.The equivalent is formally defined as the amount of a substance which will either:...

. Hyperchloremia is defined as a chloride concentration exceeding this level.

Hyperchloremia can affect oxygen transport.

Symptoms

Often hyperchloremia does not produce any symptoms. However, hyperchloremia is sometimes associated with excess fluid loss such as vomiting and diarrhea. If the sufferer were to be a diabetic, hyperchloremia could lead to poor control of blood sugar

Blood sugar

The blood sugar concentration or blood glucose level is the amount of glucose present in the blood of a human or animal. Normally in mammals, the body maintains the blood glucose level at a reference range between about 3.6 and 5.8 mM , or 64.8 and 104.4 mg/dL...

 concentration, which could cause it to become elevated. Hyperchloremia can be symptomatic with signs of Kussmaul's breathing, weakness, and intense thirst.

Causes

Elevations in chloride may be associated with diarrhea

Diarrhea

Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...

, certain kidney

Kidney

The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...

 diseases as Lightwood syndrome, and overactivity of the parathyroid gland

Parathyroid gland

The parathyroid glands are small endocrine glands in the neck that produce parathyroid hormone. Humans usually have four parathyroid glands, which are usually located on the rear surface of the thyroid gland, or, in rare cases, within the thyroid gland itself or in the chest...

s. Hyperchloremia is often comorbid

Comorbidity

In medicine, comorbidity is either the presence of one or more disorders in addition to a primary disease or disorder, or the effect of such additional disorders or diseases.- In medicine :...

 with diabetes or hyponatremia

Hyponatremia

Hyponatremia is an electrolyte disturbance in which the sodium concentration in the serum is lower than normal. In the vast majority of cases, hyponatremia occurs as a result of excess body water diluting the serum sodium and is not due to sodium deficiency. Sodium is the dominant extracellular...

. Certain drugs, especially diuretic

Diuretic

A diuretic provides a means of forced diuresis which elevates the rate of urination. There are several categories of diuretics. All diuretics increase the excretion of water from bodies, although each class does so in a distinct way.- Medical uses :...

s such as carbonic anhydrase inhibitors, hormonal

Hormone

A hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...

 treatments, and polypharmacy

Polypharmacy

Polypharmacy is the use of multiple medications by a patient, especially when too many forms of medication are used by a patient, when more drugs are prescribed than is clinically warranted, or even when all prescribed medications are clinically indicated but there are too many pills to take ....

, may contribute to this disorder.

Treatment

As with most types of electrolyte imbalance, the treatment of high blood chloride levels is based on correcting the underlying cause.

• If the patient is dehydrated, therapy consists of establishing and maintaining adequate hydration.

• If the condition is caused or exacerbated by medications or treatments, these may be altered or discontinued, if deemed prudent.

• If there is underlying kidney disease (which is likely if there are other electrolyte disturbances), then the patient will be referred to a nephrologist for further care.

• If there is an underlying dysfunction of the endocrine or hormone system, the patient will likely be referred to an endocrinologist for further assessment.

External links

• FP Notebook