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Hyperchloremia is an electrolyte disturbance in which there is an abnormally elevated level of the chloride ion in the blood. The normal serum range for chloride is 97 to 107 mEq/L. Hyperchloremia is defined as a chloride concentration exceeding this level. Hyperchloremia can affect oxygen transport.
Often hyperchloremia does not produce any symptoms. In cases where symptoms develop, manifestation resembles hypernatremia. Reduction in blood chloride leads to cerebral dehydration; symptoms are most often caused by rapid rehydration which results in cerebral edema. If the sufferer were to be a diabetic, hyperchloremia could lead to poor control of blood sugar concentration, which could cause it to become elevated. Hyperchloremia can be symptomatic with signs of Kussmaul's breathing, weakness, and intense thirst.
Elevations in chloride may be associated with administration significant amounts of IV normal saline, diarrhea, certain kidney diseases as type 2 renal tubular acidosis, type 1 renal tubular acidosis, and overactivity of the parathyroid glands. Hyperchloremia is often comorbid with diabetes or hyponatremia. Certain drugs, especially diuretics such as carbonic anhydrase inhibitors, hormonal treatments, and polypharmacy, may contribute to this disorder.
As with most types of electrolyte imbalance, the treatment of high blood chloride levels is based on correcting the underlying cause.
- If the patient is dehydrated, therapy consists of establishing and maintaining adequate hydration.
- If the condition is caused or exacerbated by medications or treatments, these may be altered or discontinued, if deemed prudent.
- If there is underlying kidney disease (which is likely if there are other electrolyte disturbances), then the patient will be referred to a nephrologist for further care.
- If there is an underlying dysfunction of the endocrine or hormone system, the patient will likely be referred to an endocrinologist for further assessment.
- Cambier C, Detry B, Beerens D, et al. (October 1998). "Effects of hyperchloremia on blood oxygen binding in healthy calves". J. Appl. Physiol. 85 (4): 1267–72. PMID 9760315.