Chloride - Electrolytes

Chloride

·        Anion Gap = Na + K – (Cl + HCO₃)

o  Usually 8 – 16 milliequivalent/l (measure of charge) 

o  High Anion Gap: Ketoacidosis, lacticacidosis, renal failure, poisoning (salicylate, methanol, ethanol, ethylene glycol)

o  Low anion Gap: GI or GI loss of HCO₃, therapy for diabetic ketoacidosis, ingestion of HCl or NH4Cl

o  Practical use limited – cause of metabolic acidosis obvious from history and observation

o  Most labs have deleted it from electrolyte profile

·        Cl normally tracks Na except in metabolic acidosis. Eg severe vomiting: ¯HCl (® hypochloraemic metabolic alkalosis) and volume depletion (® kidney retains Na ® generation of HCO₃ and K depletion). Correction of alkalosis requires correction of volume, chloride and K