Hyperchloremia

Hyperchloremia is defined as Cl- > 105 mmol/l.

Pathogenesis
Hyperchloremia almost always accompanies sodium loss, water and bicarbonate and is associated with  metabolic acidosis (MAC). The opposite may be iatrogenic-induced hyperchloraemia with over-infusion of 1/1 saline.

Etiology
The finding of hyperchloraemic acidosis must always indicate the possibility of renal tubular acidosis and also occurs in diarrhea with hypernatremia and hypokalaemia (water loss predominates).
 * increased chloride intake (most often together with sodium in infusion therapy NaCl);
 * decreased chloride excretion usually together with decreased sodium excretion (cardiac insufficiency, renal insufficiency);
 * hyperchloremic acidosis without change in the overall chloride balance.

Clinical picture
An excess of chlorides does not have its own clinical manifestations.

Therapy
Hyperchloremia is corrected by treating the underlying disorder, and the condition rarely requires a reduction in chlorine intake and an increase in excretion by diuretics.

Source

 * HAVRÁNEK, Jiří: Dysbalance of chlorine . (managed)

Related article

 * Hypochloraemia