Chloride

Chloride, the principal inorganic anion of extracellular fluid, is important in maintaining normal acid-base balance and normal osmolality. If chloride is lost (as HCl or NH4Cl), alkalosis ensues; if chloride is ingested or retained, acidosis ensues. 

Normal Range: 98-107 meq/L

increased in: Renal failure, nephrotic syndrome, renal tubular acidosis, dehydration, overtreatment with saline, hyperparathyroidism, diabetes insipidus, metabolic acidosis from diarrhea (loss of HCO3), respiratory alkalosis, hyperadrenocorticism. Drugs: acetazolamide (hyperchloremic acidosis), androgens, hydrochlorothiazide, salicylates (intoxication).  

Decreased in: Vomiting, diarrhea, gastrointestinal suction, renal failure combined with salt deprivation, overtreatment with diuretics, chronic repiratory acidosis, diabetic ketoacidosis, excessive sweating, SIADH, salt-losing nephropathy, acute intermittent porphyria, water intoxication, expansion of extracellular fluid volume, adrenal insufficiency, hyperaldosteronism, metabolic alkalosis. Drugs: aldosterone, chronic laxative or bicarbonate ingestion, corticosteroids and ACTH (alkalosis), diuretics