Test Name: Chloride (Cl), Blood
Specimen Type: Serum/Plasma
Specimen Required: 3-5 Cc Yellow Top Gel Vial, Green top
Lithium Heparin Vial
Day Performed: Daily
Reporting Time: 8 Hours STAT Reporting Time: 120 MINUTES
Methodology: Beckman Coulter AU480
CLINICAL SIGNIFICANCE:
A greater-than-normal level may be due to:
- Addison disease
- Carbonic anhydrase inhibitors (used to treat glaucoma)
- Diarrhea
- Ethylene glycol poisoning
- Ketoacidosis
- Kidney disease
- Lactic acidosis
- Metabolic acidosis
- Methanol poisoning
- Renal tubular acidosis – distal
- Renal tubular acidosis – proximal
- Respiratory alkalosis (compensated)
- Salicylate toxicity (such as aspirin overdose)
- Ureteral diversion
A lower-than-normal level may be due to:
- Bartter syndrome
- Burns
- Congestive heart failure
- Cushing syndrome
- Dehydration
- Excessive sweating
- Hyperaldosteronism
- Metabolic alkalosis
- Respiratory acidosis (compensated)
- Syndrome of inappropriate diuretic hormone secretion (SIADH)
- Vomiting
This test may also be done to help rule out or diagnose:
- Multiple endocrine neoplasia
- Primary hyperparathyroidism
Delirium may also alter chloride levels.
References:
- Bansal A. Respiratory acidosis, respiratory alkalosis, and mixed acid-base disorders. In: Johnson RJ, Floege J, Tonelli M, eds. Comprehensive Clinical Nephrology. 7th ed. Philadelphia, PA: Elsevier; 2024: chap 15.
- Seifter JR. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 110.