hyperchloremiaan

Hyperchloremia, sometimes written hyperchloraemia in British usage, is an electrolyte disturbance defined by an elevated concentration of chloride in the blood. In adults, serum chloride commonly exceeds 106 mEq/L. It may occur alone or with changes in other electrolytes, and it is often detected during routine blood tests rather than presenting with specific symptoms.

Common causes include a large chloride load from intravenous fluids such as normal saline (0.9% sodium chloride), especially after extensive fluid resuscitation. Other contributing factors are loss of bicarbonate through diarrhea or ileostomy, renal impairment affecting chloride handling, metabolic disturbances that reduce bicarbonate, and certain medications. Illnesses requiring intensive care or surgery can also be associated with hyperchloremia.

Pathophysiologically, hyperchloremia frequently accompanies a normal anion gap metabolic acidosis (hyperchloremic acidosis). The elevated chloride reduces the strong ion difference and alters acid-base balance, which can influence fluid status and kidney function in some patients.

Diagnosis is based on laboratory evaluation of serum electrolytes, with measurement of chloride, sodium, and bicarbonate. The anion gap is often used to classify the accompanying acid-base disturbance. Clinicians assess the patient’s volume status, renal function, and recent fluid or medication exposure to identify the underlying cause.

Management focuses on treating the cause and limiting chloride exposure. This may involve using balanced crystalloid solutions instead of high-chloride fluids, addressing dehydration or bicarbonate loss, and correcting metabolic acidosis if present. Monitoring of electrolytes and kidney function guides ongoing therapy. Prognosis varies with the underlying condition; hyperchloremia itself is usually a marker rather than a sole driver of outcomes, though pronounced or persistent elevation can signal significant illness.