Chloride

Keywords: Cl

Specimen:

5 mL blood in lithium heparin or plain tube.

Method:

Spectrophotometry, coulometry or ISE.

Reference Interval:

See Table 6.

Application:

To assess the possible cause of acid-base disturbances, including calculation of the anion gap.

Interpretation:

Hyponatraemia and metabolic alkalosis are associated with hypochloraemia.

Hypernatraemia and metabolic acidosis, due to renal tubular acidosis or bicarbonate loss, are associated with hyperchloraemia.

An increased anion gap indicates accumulation of an anion other than chloride (eg, lactate, hydroxybutyrate); this usually occurs with metabolic acidosis.

Reference:

Madias NE et al. N Engl J Med 1979; 300(25): 1421-1423.