What is Hyperchloremia?

Hyperchloremia is an unusually high level of chloride in the blood. Chloride is an essential electrolyte that regulates certain metabolic processes. When levels are high, it can interfere with blood sugar levels, as well as oxygen transport, leading to health problems for the patient. Symptoms are not usually noticed until the chloride level rises very high and certain people are more vulnerable to a rise in chloride levels than others.

This anion is normally present in the blood in concentrations of around 97 to 107 milliequivalents per liter of blood. Levels can become high in people who are dehydrated because the body is not receiving enough water for the kidneys to properly balance electrolytes. Kidney and parathyroid disease can lead to skews in electrolyte levels including hyperchloremia, and people with diabetes are also at risk. For people with known risks, a doctor may recommend close monitoring of electrolyte levels.

People with hyperchloremia often develop dehydration and may lose fluids through vomiting and diarrhea. Their blood sodium level will be high and diabetic patients can have high blood sugar levels. When a patient is diagnosed, the first step is determining why chloride levels got so high. If dehydration is a culprit, the patient can be provided with fluids to rehydrate and stabilize the electrolyte balance. The cause of the dehydration must also be explored and addressed.

If an underlying disease process is leading to hyperchloremia, it is necessary to treat the disease. Treating the condition should cause chloride levels to return to normal. The patient may be monitored during treatment and tested on follow up visits to confirm that the electrolyte balance is stable. This testing can include tests that confirm that the cause of the hyperchloremia is well under control, as for example in patients with chronic kidney disease who are regularly tested for signs of changes in their status.

People can reduce the risk of hyperchloremia and other electrolyte imbalances by staying properly hydrated, especially in hot weather and while exercising. Drinking water and other fluids will help people retain moisture and electrolyte replacements can be used for people who are losing a lot of fluid, to avoid introducing pure water to the body and causing a drop in electrolyte levels. People at risk for hyperchloremia including people with diabetes and kidney disease should remain alert to signs of medical complications that might indicate that their current approach to treatment and management of their conditions is not working.