Clinical background:
Chloride is an electrolyte. Most of the chloride in the diet is attached to sodium in the form of sodium chloride. It is the major extracellular anion and it is important in maintaining normal acid-base balance and, along with sodium, in keeping normal levels of water in the body. Chloride generally increases or decreases in direct relationship to sodium, but may change without any change in sodium when there are problems with acid-base balance. Chloride is taken into the body through food. Most of the chloride is absorbed by the GI tract, and the excess excreted in urine. Blood chloride may be useful, along with sodium, to evaluate problems with the acid-base balance in the body and to monitor treatment.
Specimen container paediatric:
Serum (SST or plain tube)
Specimen container adult:
Serum (SST or plain tube)
Minimum volume paediatric:
0.5 mL blood
Minimum volume adult:
1 mL blood
Sample stability:
Unseparated sample:
24 hours
Separated sample:
at 15 to 25C: 7 days
at 2 to 8C: 7 days
at -20C: 1 year
Transport requirements:
Ambient
Hyperchloraemia occurs alongside hypernatraemia in conditions such as cardiac failure, liver disease, renal disease and hyperaldosteronism. However in certain types of metabolic acidosis hyperchloraemia occurs withour hypernatraemia. Hypochloraemia occurs alongside hyponatraemia where there are excess losses such as GI (vomiting, diarrhea, fistula), excessive sweating and renal disease and with adrenal insufficiency, diuretic therapy, burns, SIADH and where there is an osmotic diuresis e.g. diabetes mellitus. However, in hypochloraemic metabolic alkalosis chloride depletion can occur without concurrent hyponatraemia where chloride is lost in excess of sodium.
Reference ranges:
Up to 4 weeks: 98 – 113 mmol/L
4 weeks and over: 95 – 108 mmol/L
Other info:
Plasma- Lithium Heparin also acceptable