Hyperchloremia is a disorder in which a person has too much chloride in their blood. Chloride is an electrolyte, and changes in electrolyte levels can cause dehydration.
Electrolytes such as chloride, sodium, and bicarbonate are minerals that dissolve in the fluids of the body. With careful management of fluids and food, and with prompt treatment for any underlying conditions, most people can regain normal electrolyte levels.
When the body is stressed, electrolyte levels may become imbalanced. The kidneys help regulate electrolyte levels, so electrolyte problems can signal a problem with the kidneys.
Hyperchloremia often points to another problem. People discover they have hyperchloremia as part of a collection of tests to measure electrolyte levels.
A doctor may order these tests if a person appears to have nutritional or fluid imbalances, kidney problems, or is undergoing chemotherapy. Chloride helps the body maintain its fluid balance. It also helps make the digestive enzymes that help the body metabolize food. Changes in chloride levels can harm these functions.
When chloride levels are moderately high, a person may not notice any symptoms. Long-term hyperchloremia, however, can cause a range of symptoms. The severity of symptoms depends on how high chloride levels are, how long they have remained that high, and individual factors such as:. The symptoms of hyperchloremia and electrolyte imbalances are so general that it is impossible to diagnose this syndrome based on symptoms alone. People should not self-diagnose. A study that measured chloride levels in healthy infants, as well as preterm infants and those with health issues, found that chloride levels rose in the week following birth.
Chloride helps keep the acid and base balance in the body. Return to list of Blood Test Abnormalities. Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments.
The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.
Alternatively, some forms of diarrhea cause the excretion of bicarbonate, which increases chloride retention [ 16 ]. Chloride buildup linked to metabolic acidosis also occurs in a condition in which the kidneys fail to absorb bicarbonate proximal kidney tubular acidosis or in patients suffering from chronic kidney failure [ 17 , 18 ].
Blockers of the enzyme that transforms carbon dioxide into bicarbonate carbonic anhydrase II also promote chloride buildup [ 19 ]. Excessive exposure to certain organic acids e. Positive and negative charges in the blood must be balanced to remain electrically neutral.
Conditions promoting the increased buildup of positive electrolytes such as sodium and potassium in the blood will lead to the excessive accumulation of chloride [ 21 ]. Several studies found a link between high blood chloride levels and increased incidence of kidney injury:.
In an observational study on over patients who underwent kidney transplantation, no association could be found between high blood chloride levels in the donor and the incidence of acute kidney injury in the recipient [ 43 ].
Infusion of 0. A relationship between high blood chloride levels and increased death rate of critically ill patients has been demonstrated in these studies:. In 2 clinical trials on over people undergoing major surgery, those infused with 0. Infusion with a balanced solution induced higher circulating levels of cytokines than with 0. High blood chloride concentrations increased the circulating cytokine levels in a study in rats with septic shock but failed to do so in a similar experiment [ 57 , 58 ].
In two cell studies, exposure to a chloride-concentrated solution reduced the activation and attachment to the inner blood vessel lining of white blood cells, suggesting that infusion with high-chloride fluids reduces the risk of septic shock [ 59 , 60 ].
In a meta-analysis of 21 studies involving over 6, critically ill people, infusion with high-chloride fluids was associated with the requirement for longer mechanical ventilation times [ 27 ].
In two observational studies on almost 32, people undergoing surgery and over 3, with systemic inflammatory syndrome, infusion with 0. Infusion with 0. In many cases, too much chloride might be caused by kidney problems and their inability to regulate this substance properly. In some cases, a patient can develop hyperchloremic acidosis. This is a condition in which either your body loses an alkaline substance or preserves too many acidic substances.
This can also be caused by severe diarrhea, the use of certain drugs, or kidney damage. As mentioned earlier, the most accurate way to determine if you have too much chloride in your blood is by using a blood test. You can order an individual blood test for this particular electrolyte only. It's usually called a chloride blood test. However, it's recommended to test other electrolytes and related substances in your body. This will give you a broader view of your pH balance, kidney function, and the way your system processes electrolytes such as chloride.
You can do that by ordering a Comprehensive Metabolic Panel. This is a group of blood tests that checks your sodium, potassium, calcium, chloride, and carbon dioxide levels.
Other substances, enzymes, and proteins might be checked too such as albumin, bilirubin, blood urea nitrogen, and so on. This helps doctors rule out other potential health problems and find out exactly why you have too much chloride in the blood. The results of such a complex blood test are usually back within a few business days, so in about a week you'll have an accurate answer.
Keep in mind that too much chloride in your blood might be caused by a set of kidneys that don't work properly.
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