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| ==Overview== | | ==[[Hyperchloremia overview|Overview]]== |
| ''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.
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| ==Symptoms== | | ==[[Hyperchloremia classification|Classification]]== |
| Often hyperchloremia does not produce any symptoms. However, hyperchloremia is sometimes associated with excess fluid loss such as vomiting and diarrhea. If the sufferer is a diabetic, hyperchloremia may lead to poor control of blood sugar levels, causing them to become elevated. Hyperchloremia can be symptomatic with signs of Kussmaul's breathing, weakness, and intense thirst.
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| ==Causes==
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| Elevations in chloride may be associated with [[diarrhea]], certain [[kidney]] diseases, and overactivity of the [[parathyroid gland]]s. Hyperchloremia is often [[comorbidity|comorbid]] with [[diabetes]] or [[hyponatremia]]. Certain drugs, especially [[diuretic]]s such as carbonic anhydrase inhibitors, [[hormone|hormonal]] treatments, and [[polypharmacy]], may contribute to this disorder.
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| === Complete Differential Diagnosis of the Causes of Hyperchloremia=== | | ==[[Hyperchloremia pathophysiology|Pathophysiology]]== |
| (In alphabetical order)
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| * Artifact (low [[anion gap]])
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| * [[Dehydration]]
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| * [[Drugs]]
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| * [[Hypernatremia]]
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| * [[Hyperparathyroidism]]
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| * Ileul loops
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| * Loss of pancreatic secretion
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| * [[Metabolic acidosis]]
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| * [[Nephrotic syndrome]]
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| * Prolonged [[diarrhea]]
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| * [[Renal failure]]
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| * [[Renal tubular acidosis]]
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| * [[Respiratory alkalosis]]
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| * [[Ureter]]al [[colon]]ic [[anastomosis]]
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| ===Complete Differential Diagnosis of the Causes of Hyperchloremia=== | | ==[[Hyperchloremia causes|Causes]]== |
| (By organ system)
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| {|style="width:80%; height:100px" border="1"
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| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
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| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Chemical / poisoning'''
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| |bgcolor="Beige"| [[Drugs]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Dermatologic'''
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| |bgcolor="Beige"| No underlying causes
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| |- | |
| |-bgcolor="LightSteelBlue"
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| | '''Drug Side Effect'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Ear Nose Throat'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Endocrine'''
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| |bgcolor="Beige"| [[Hyperparathyroidism]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Environmental'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Gastroenterologic'''
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| |bgcolor="Beige"| Ileul loops, Loss of pancreatic secretion, Prolonged [[diarrhea]], [[Ureter]]al [[colon]]ic [[anastomosis]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Genetic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Hematologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Iatrogenic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Infectious Disease'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Musculoskeletal / Ortho'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Neurologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Nutritional / Metabolic'''
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| |bgcolor="Beige"| [[Dehydration]], [[Hypernatremia]], [[Metabolic acidosis]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Obstetric/Gynecologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Oncologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Opthalmologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Overdose / Toxicity'''
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| |bgcolor="Beige"| [[Drugs]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Psychiatric'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Pulmonary'''
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| |bgcolor="Beige"| [[Respiratory alkalosis]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Renal / Electrolyte'''
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| |bgcolor="Beige"| Artifact (low [[anion gap]]), [[Dehydration]], [[Hypernatremia]], [[Metabolic acidosis]], [[Nephrotic syndrome]], [[Renal failure]], [[Renal tubular acidosis]], [[Respiratory alkalosis]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Rheum / Immune / Allergy'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Sexual'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Trauma'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Urologic'''
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| |bgcolor="Beige"| [[Nephrotic syndrome]], [[Renal failure]], [[Renal tubular acidosis]], [[Ureter]]al [[colon]]ic [[anastomosis]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Miscellaneous'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |}
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| | ==[[Hyperchloremia differential diagnosis|Differentiating Hyperchloremia from other Diseases]]== |
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| ==Treatment== | | ==[[Hyperchloremia epidemiology and demographics|Epidemiology and Demographics]]== |
| As with most types of electrolyte imbalance, the treatment of high blood chloride levels is based on correcting the underlying cause.
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| | ==[[Hyperchloremia risk factors|Risk Factors]]== |
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| | ==[[Hyperchloremia natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| *If the patient is dehydrated, therapy consists of establishing and maintaining adequate hydration.
| | ==Diagnosis== |
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| *If the condition is caused or exacerbated by medications or treatments, these may be altered or discontinued, if deemed prudent.
| | [[Hyperchloremia history and symptoms|History and Symptoms]] | [[Hyperchloremia physical examination|Physical Examination]] | [[Hyperchloremia laboratory findings|Laboratory Findings]] | [[Hyperchloremia other diagnostic studies|Other Diagnostic Studies]] |
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| *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.
| | ==Treatment== |
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| *If there is an underlying dysfunction of the endocrine or hormone system, the patient will likely be referred to an [[endocrinologist]] for further assessment.
| | [[Hyperchloremia medical therapy|Medical Therapy]] | [[Hyperchloremia primary prevention|Primary Prevention]] |
| | ==Case Studies== |
| | [[Hyperchloremia case study one|Case #1]] |
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| | ==Related Chapters== |
| | *[[Renal tubular acidosis|Renal Tubular Acidosis]] |
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| {{Endocrine, nutritional and metabolic pathology}} | | {{Endocrine, nutritional and metabolic pathology}} |