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
