Test Findings
Test Findings
 

Hyperchloraemia

Bookmark

Overview

  • Hyperchloraemia rarely exists on its own, and is usually found in the presence of hypernatraemia (due to water loss or salt gain) or normal anion gap (hyperchloraemic) metabolic acidosis. Hyperchloraemia can also occur in the setting of renal compensation for respiratory alkalosis.

Aetiology

    • Causes of Hyperchloraemia

    • Water Loss

    • Inadequate water intake
    • Diabetes insipidus (neurogenic / nephrogenic)
    • Loop diuretics
    • Acute tubular necrosis (polyuric phase)
    • Osmotic diuresis (e.g. poorly controlled diabetes)
    • Non-urinary loss - insensible, sweat, burns, diarrhoea
    • Salt Gain

    • Excessive administration - dietary excess, hypertonic saline, hypertonic dialysis
    • Hyperaldosteronism
    • Cushings
    • Hyperchloraemic Metabolic Acidosis

    • GI loss - diarrhoea, fistula, stoma
    • Isotonic saline infusion
    • Renal tubular acidosis
    • Acetazolamide
    • Addison’s disease
    • Compensation for Respiratory Alkalosis

    • Hyperventilation - hypoxia, anxiety, pain, intracranial pathology, pregnancy

Approach

  • Determine whether the patient is hypernatraemic or has an acid-base abnormality, and then investigate further depending on the result.
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge
Explore
   
 
Feedback