Hyperchloremia (patient information)

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Hyperchloremia
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
Diagnosis
When to seek urgent medical care?
Treatment options
Where to find medical care for Hyperchloremia?
Prevention
What to expect (Outlook/Prognosis)?
Possible complications
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Assistant Editor-In Chief: Dipen Kumar[2]

Overview

Hyperchloremia is a condition where the amount of chloride ions (Cl^-) in the body are too high. This condition can affect the transport of oxygen.

What are the symptoms of Hyperchloremia?

Often, hyperchloremia does not produce symptoms. Symptoms may include:

• Excessive fluid loss (Diarrhea, Vomiting)
• Dyspnea (shortness of breath)
• Intense thirst
• Weakness
• Tachypnea (rapid breathing)
• Hypertension (high blood pressure)
• Pitting Edema (abnormal amount of fluid under the skin, causing swelling)
• Lowered cognitive ability
• Kussmaul's breathing (very deep and labored breathing at a normal or reduced rate)
• Coma

If the sufferer is a diabetic, hyperchloremia can cause high levels of blood sugar.

What causes Hyperchloremia?

Hyperchloremia is caused by:

1. Low Anion Gap (when the difference in positive and negative ions in the serum is low)
2. Metabolic and Endocrine
   • Diabetic coma
   • Diabetes insipidus
   • Hyperparathyroidism
   • Metabolic Acidosis
   • Type I and II Renal Tubular Acidosis
   • Hypernatremia
3. Gastorintestinal
   • Dehydration
   • Ileal conduits
   • Kidney diseases
   • Loss of pancreatic secretion
   • Prolonged Diarrhea
   • Ureteral colonic anastomosis
   • Vomiting
4. Brain stem injury causing neurogenic hyperventilation
5. Medications
   • Androgens
   • Corticosteroids
   • Diuretics
   • Estrogens

Who is at highest risk?

People who are at risk are patients who have diabetes or kidney diseases.

Diagnosis

Tests can be done to check your serum:

• If your serum chloride levels are greater than 106 mEq/L you have hyperchloremia
• Serum pH is under 7.35
• Serum carbon dioxide levels less than 22 mEq/L.

A chloride test can be done on a sample of the total urine collected over a 24-hour period (24-hour urine sample) to find out how much chloride is excreted.

When to seek urgent medical care?

Consult a doctor immediately if you have any of these:

• Drowsiness or confusion
• Extreme nausea that interferes with eating and not relieved by medicines
• Having diarrhea 4 to 6 times in a day that is not relieved by diet modification or anti-diarrhea drugs
• Irritability and muscle twitching
• Poor appetite and increased urination
• Severe constipation for 2 to 3 days, and not relieved by laxatives
• Vomiting more than 4 to 5 times in a day

Treatment options

Since hyperchloremia is just an ion imbalance, the usual treatment is correcting the cause of the hyperchloremia. If caused by:

• Dehydration- therapy to maintaining enough hydration
• Dysfunctional endocrine/hormone system- refer to an endocrinologist
• Kidney diseases- refer to a nephrologist
• Medications- if they are caused or made worse by drugs, stop or alter the treatment

Where to find medical care for Hyperchloremia?

Directions to Hospitals Treating Hyperchloremia

Prevention

Some ways to prevent hyperchloremia include:

• Supplementing magnesium in your food, under the doctor's supervision only.
• Since our diet is the most common source of how we intake chloride, controlling it can keep the levels of chloride within the normal levels .
• In accordance with the National Institute of Health, adults should be consumeing 2 to 2.3 grams of chloride every day. As age increases the necessity decreases; however, necessity increases during pregnancy.
• Foods like celery, lettuce, olives, tomatoes etc. have a lot of chloride. These foods should be consumed less if there is higher amounts of chloride in the body.

What to expect (Outlook/Prognosis)?

When going to the doctor you will be asked some of these question and be administered a blood test to check for abnormalities, the questions might be:

• How long have you had the symptoms?
• Do you have a history with diabetes, kidney disease or heart diseases?
• What medicines are you currently taking (including over-the-counter, vitamins or herbal remedies)?

Possible complications

Possible complications are related to the underlying disorder of the hyperchloremia.

Neurologic complications include CNS thrombosis or hemorrhage, seizures, and hyperactivity.

Sources

http://chemocare.com/chemotherapy/side-effects/hyperchloremia-high-chloride.aspx#.Ug9NXudkz0p

http://en.wikipedia.org/wiki/Hyperchloremia

http://healthooze.com/hyperchloremia/

http://users.silenceisdefeat.net/mindful/data/02080209.html

http://www.ncbi.nlm.nih.gov/pubmed/23757473

http://www.nlm.nih.gov/medlineplus/ency/article/003485.htm

http://www.wisegeek.com/what-is-hyperchloremia.htm