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What is Hyperchloremia?

Mary McMahon
Updated Mar 03, 2024
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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.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments

By indigomoth — On Nov 26, 2011

I have a friend who is diabetic and I always feel so bad for her at how many different problems she has to deal with all the time. Like this one for example. She not only has to maintain her blood sugar levels, she has to really watch her dehydration levels as well.

She is kind of stubborn about not letting it get to her though. She runs marathons as a hobby! And has never had a problem, although the doctors warned her that hyperchloremia and other conditions could be an issue.

I think it's very inspirational, and shows other people that if you are careful about it, you really can do anything.

By croydon — On Nov 25, 2011

@umbra21 - I remember when I was playing kickball as a kid and we had a girl suffer from dehydration. She basically fainted on the field. Luckily, one of the coaches had done some first aid courses and realized what was probably wrong with her, so she got some water and sports drinks into her and kept damp towels on her forehead and hands until she was better.

She told us she never even felt thirsty, she just felt really hot and tired. So I believe you when you say that it can really creep up on you. Luckily, she didn't suffer from any side effects like hyperchloremia, but imagine if she had been diabetic or something like that?

Particularly, since the treatment for dehydration involves sport drinks which have so much sugar. It would be really dangerous to mess around with that. Better to just be cautious in the first place.

By umbra21 — On Nov 24, 2011

Dehydration is so dangerous and people don't realize how easy it is to get it in some situations. I've heard stories about people on hikes who have died from dehydration with water in their packs, just because they didn't keep drinking and then didn't realize what was the matter with themselves.

After a certain point, you might become too disoriented to actually take care of yourself or think to drink some water, and by that point you might also be low on electrolytes as well.

The best way to prevent it is to make yourself drink water every half hour or so, particularly in hot weather. Remember, you might not feel thirsty until it's already too late.

Mary McMahon

Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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