Definition
Chloride, like potassium, sodium and calcium, is an important electrolyte that is involved in the body’s everyday metabolic processes. It is present in the body in negative charge and is also called an anion. Chloride plays an important role in cardiac control, in the transmission of nerve impulses and in the control of the water balance.
Furthermore, chloride is also attributed an important role in the regulation of the acid-base balance. Chloride is taken up with food, mostly by common salt (NaCl), and is excreted via the kidneys after it has fulfilled its metabolic tasks. A diet that is very low in salt usually also leads to a lack of sodium and chloride.
Standard values
Chloride is determined in patients in serum by a blood test. The standard value in most laboratories is between 96 and 110 mmol/l. Here the values differ slightly from laboratory to laboratory and also whether adults or children are being tested. In children, the standard chloride value in serum is between 95 and 112 mmol/l.
Increased chloride levels and symptoms
There are some circumstances and diseases where an elevated chloride level in blood serum can be detected. In most cases, minor chloride deficiencies do not cause any complaints. However, the more severe the deficiency becomes, the more severe the symptoms become.
The first symptoms that people with a severe chloride deficiency experience are malaise and nausea, sometimes vomiting. Furthermore, the metabolic processes in the body for which chloride is necessary no longer run as smoothly. There are numerous diseases in which the acid-base balance of the body becomes imbalanced and in which the chloride level in the blood rises.
The so-called renal-tubular acidosis is an example of a disease with increased chloride levels. It occurs in kidney diseases and inflammation of the kidney, in diabetes mellitus, after ureteral surgery or due to genetic causes. In addition, autoimmune diseases can also lead to an imbalance of electrolytes with an increase in chloride in the blood.
Diseases of the central nervous system also lead to an increased chloride level, as does so-called hyperventilation, in which the patient inhales and exhales faster than usual and a normal gas exchange in the lungs no longer takes place. This causes chloride to accumulate in the blood. Chloride can also increase with fever, but usually not so high as to cause symptoms.
In chronic diarrhoea, the chloride level in the blood can also rise. There are also some drugs that can have the same effect in the blood. So-called carboanhydrase inhibitors, which are used to treat epilepsy or glaucoma, can lead to an imbalance of electrolytes and also chloride.
The rather rare drug administration of bromide also leads to an increase in chloride in the blood. There are also some chloride-containing drugs that contribute to an increase in the chloride level in the blood. In most cases, the chloride is a carrier substance of a normal drug. These include ammonium chloride, arginine chloride or lysine chloride.