Serum chloride measurement is used to evaluate the body's acid-base balance, electrolyte control, and hydration status.
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Chloride (chloride, Cl-) is the major anion of the extracellular fluid. Chloride levels are inversely related to those of bicarbonate, thus reflecting the acid-base status. Chloride has several functions, including maintaining electrical neutrality by neutralizing cations such as sodium (NaCl, HCl), acting as a component of the pH buffer system, aiding digestion, and helping maintain osmotic pressure and water balance. Because chlorine is so often found in combination with sodium, changes in sodium levels lead to corresponding changes in chloride levels.
Patients with elevated chloride levels (hyperchloremia) may experience weakness, deep and rapid breathing, drowsiness, and lethargy, which may progress to coma. Patients with hypochloremia or decreased serum chloride concentration may present with muscle hypertonicity, tetany, and shallow breathing. A blood test for chloride is often performed as part of a screening laboratory test. Screening patients with prolonged vomiting, diarrhea, or weakness may also be needed.
Possible Interpretations of Pathological Values
- Increase: Acute renal failure, alcoholism, anemia, heart failure, Cushing's syndrome, dehydration, diabetes insipidus, eclampsia, excessive saline infusion, hyperparathyroidism, hyperventilation, metabolic acidosis, multiple myeloma, renal tubular acidosis, respiratory alkalosis, salicylate poisoning. Medications: Acetazolamide, ammonium chloride, androgens, boric acid, cholestyramine, cyclosporine, estrogens, glucocorticoids, imipenem-cilastatin, methyldopa, nonsteroidal anti-inflammatory drugs, phenylbutazone sodium bromide, sodium chloride, spironolactone, thiazide diuretics
- Decrease: Acute infections, Addison's disease, adrenal insufficiency, burns, chronic renal failure, congestive heart failure, diabetic acidosis, diarrhea, sweating, heat exhaustion, hypokalemia, hyponatremia, metabolic alkalosis, nasogastric aspiration, primary aldosteronism, pulmonary emphysema, pyloric obstruction, ulcerative colitis, vomiting. Medications: Aldosterone, amiloride, bumetanide, corticosteroids, corticotropin, dextrose infusions, ethacrynic acid, furosemide, loop diuretics, prednisolone, sodium bicarbonate, spironolactone, triamterene, thiazide diuretics
Important Note
Laboratory test results are the most critical parameter for diagnosing and monitoring all pathological conditions. Between 70 to 80% of diagnostic decisions are based on laboratory tests. Correctly interpreting laboratory results allows a doctor to distinguish "healthy" from "diseased."
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be analyzed based on each case and family history, clinical findings, and the results of other laboratory tests and information. Your physician should explain the importance of your test results.
At Diagnostiki Athinon, we answer any questions you may have about the test you perform in our laboratory and contact your doctor to ensure you receive the best possible medical care.
