Hypochloremia

Abnormally decreased concentration of chloride ions in the blood (normal range: 96–106 mmol/L or mEq/L), often associated with disturbances in fluid balance and acid-base homeostasis, including metabolic alkalosis or chronic respiratory acidosis.

Causes

• Gastrointestinal fluid loss

  • Vomiting

  • Nasogastric tube suction

  • Diarrhea

• Fluid and electrolyte loss causes

  • Excessive sweating

  • Burn injuries

  • Dehydration with electrolyte imbalance

• Medications causing renal chloride loss: Loop diuretics

• Kidney failure

• Adrenal insufficiency

• Heart failure

• Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

• Chronic respiratory acidosis --> compensatory renal bicarbonate retention and chloride loss

  • Emphysema or COPD

• Metabolic alkalosis

• Hypervolemia: Excessive free water intake --> dilutional hypochloremia