Serum chloride

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Pathophysiology sample values
BMP/ELECTROLYTES:
Na+ = 140 Cl− = 100 BUN = 20/
Glu = 150
K+ = 4 CO2 = 22 PCr = 1.0\
ARTERIAL BLOOD GAS:
HCO3− = 24 p a CO2 = 40 p a O2 = 95 pH = 7.40
ALVEOLAR GAS:
p A CO2 = 36 p A O2 = 105 A-a g = 10
OTHER:
Ca = 9.5 Mg2+ = 2.0 PO4 = 1
CK = 55 BE = −0.36 AG = 16
SERUM OSMOLARITY/RENAL:
PMO = 300 PCO = 295 POG = 5 BUN:Cr = 20
URINALYSIS:
UNa+ = 80 UCl− = 100 UAG = 5 FENa = 0.95
UK+ = 25 USG = 1.01 UCr = 60 UO = 800
PROTEIN/GI/LIVER FUNCTION TESTS:
LDH = 100 TP = 7.6 AST = 25 TBIL = 0.7
ALP = 71 Alb = 4.0 ALT = 40 BC = 0.5
AST/ALT = 0.6 BU = 0.2
AF alb = 3.0 SAAG = 1.0 SOG = 60
CSF:
CSF alb = 30 CSF glu = 60 CSF/S alb = 7.5 CSF/S glu = 0.4

Chloride is an anion in the human body needed for metabolism (the process of turning food into energy). [1] It also helps keep the body's acid-base balance. The amount of serum chloride is carefully controlled by the kidneys. [2]

The chloride ion is the anion Cl−. It is formed when the element chlorine gains an electron or when a compound such as hydrogen chloride is dissolved in water or other polar solvents. Chloride salts such as sodium chloride are often very soluble in water. It is an essential electrolyte located in all body fluids responsible for maintaining acid/base balance, transmitting nerve impulses and regulating fluid in and out of cells. Less frequently, the word chloride may also form part of the "common" name of chemical compounds in which one or more chlorine atoms are covalently bonded. For example, methyl chloride, with the standard name chloromethane is an organic compound with a covalent C−Cl bond in which the chlorine is not an anion.

Renal reabsorption of chloride (Cl−) is a part of renal physiology, in order not to lose too much chloride in the urine.

Chloride ions have important physiological roles. For instance, in the central nervous system, the inhibitory action of glycine and some of the action of GABA relies on the entry of Cl− into specific neurons. Also, the chloride-bicarbonate exchanger biological transport protein relies on the chloride ion to increase the blood's capacity of carbon dioxide, in the form of the bicarbonate ion; this is the mechanism underpinning the chloride shift occurring as the blood passes through oxygen-consuming capillary beds.

Physiology science of the function of living systems

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Central nervous system part of the nervous system consisting of the brain and spinal cord

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The normal blood reference range of chloride for adults in most labs is 96 to 106 milliequivalents (mEq) per liter. The normal range may vary slightly from lab to lab. Normal ranges are usually shown next to results in the lab report. A diagnostic test may use a chloridometer to determine the serum chloride level.

An equivalent is the amount of a substance that reacts with an arbitrary amount of another substance in a given chemical reaction. It is an archaic unit of measurement that was used in chemistry and the biological sciences in the era before researchers knew how to determine the chemical formula for a compound. The mass of an equivalent is called its equivalent weight.

A chloridometer is a measuring instrument used to determine the concentration of chloride ions (Cl–) in a solution. It uses a process known as coulometric titration or amperostatic coulometry, the accepted electrochemistry reference method to determine the concentration of chloride in biological fluids, including blood serum, blood plasma, urine, sweat, and cerebrospinal fluid. The coulometry process generates silver ions, which react with the chloride to form silver chloride (AgCl).

The North American Dietary Reference Intake recommends a daily intake of between 2300 and 3600 mg/day for 25-year-old males.

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Reference ranges for blood tests, showing blood content of chloride at far right in the spectrum. Reference ranges for blood tests - by molarity2.svg
Reference ranges for blood tests, showing blood content of chloride at far right in the spectrum.

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Hyperchloremia is an electrolyte disturbance in which there is an elevated level of the chloride ions in the blood. The normal serum range for chloride is 96 to 106 mEq/L, therefore chloride levels at or above 110 mEq/L usually indicate kidney dysfunction as it is a regulator of chloride concentration. As of now there are no specific symptoms of hyperchloremia, however, it can be the influenced by multiple abnormalities that cause a loss of electrolyte-free fluid, loss of hypotonic fluid, or increased administration of sodium chloride. These abnormalities are caused by diarrhea, vomiting, increased sodium chloride intake, renal dysfunction, diuretic use, and diabetes. Hyperchloremia should not be mistaken for hyperchloremic metabolic acidosis as hyperchloremic metabolic acidosis is characterized by two major changes: a decrease in blood pH and bicarbonate levels, as well as an increase in blood chloride levels. Instead those with hyperchloremic metabolic acidosis are usually predisposed to hyperchloremia.

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Chloride shift (also known as the Hamburger phenomenon or lineas phenomenon, named after Hartog Jakob Hamburger) is a process which occurs in a cardiovascular system and refers to the exchange of bicarbonate (HCO3−) and chloride (Cl−) across the membrane of red blood cells (RBCs).

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References

  1. ↑ "Blood (Serum) Chloride Level Test". Archived from the original on March 31, 2009. Retrieved April 30, 2010.
  2. ↑ Morrison, Gail (1990). Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Butterworth Publishers. PMID   21250151.


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