Sorted By Test Name - Mayo Medical Laboratories

RCHLU
83747
CL
8460
Reference Values:
0-15 years: not established
> or =16 years: 0-39 mEq/kg
Clinical References: 1. Phillips S, Donaldson L, Geisler K, et al: Stool composition in factitial
diarrhea: a 6-year experience with stool analysis. Ann Intern Med 1995;123:97-100 2. Holmberg C:
Congenital chloride diarrhea. Clin Gastroenterol 1986;15:583-602
Chloride, Random, Urine
Clinical Information: Chloride is the major extracellular anion. Its precise function in the body is not
well understood; however, it is involved in maintaining osmotic pressure, proper body hydration, and
electric neutrality. In the absence of acid-base disturbances, chloride concentrations in plasma will
generally follow those of sodium (Na+). Since urine is the primary mode of elimination of ingested
chloride, urinary chloride excretion during steady state conditions will reflect ingested chloride, which
predominantly is in the form of sodium chloride (NaCl). However, under certain clinical conditions, the
renal excretion of chloride may not reflect intake. For instance, during states of extracellular volume
depletion, urine chloride (and sodium) excretion is reduced.
Useful For: An indicator of fluid balance and acid-base homeostasis
Interpretation: Urine sodium and chloride excretion are similar and, under steady state conditions,
both the urinary sodium and chloride excretion reflect the intake of NaCl. During states of extracellular
volume depletion, low values indicate appropriate renal reabsorption of these ions, whereas elevated
values indicate inappropriate excretion (renal wasting). Urinary sodium and chloride excretion may be
dissociated during metabolic alkalosis with volume depletion where urine sodium excretion may be high
(due to renal excretion of NaHCO3) while urine chloride excretion remains appropriately low.
Reference Values:
No established reference values
Clinical References: 1. Tietz Textbook of Clinical Chemistry. 3rd edition. Edited by CA Burtis, ER
Ashwood. Philadelphia, WB Saunders Co, 1999 2. Toffaletti J: Electrolytes. In Professional Practice in
Clinical Chemistry: A Review. Edited by DR Dufour, N Rifai. Washington, AACC Press, 1993 3. Kamel
KS, Ethier JH, Richardson RM, et al: Urine electrolytes and osmolality: when and how to use them. Am J
Nephrol 1990;10:89-102
Chloride, Serum
Clinical Information: Chloride (Cl) is the major anion in the extracelullar water space; its
physiological significance is in maintaining proper body water distribution, osmotic pressure, and normal
anion-cation balance in the extracellular fluid compartment. Chloride is increased in dehydration, renal
tubular acidosis (hyperchloremia metabolic acidosis), acute renal failure, metabolic acidosis associated
with prolonged diarrhea and loss of sodium bicarbonate, diabetes insipidus, adrenocortical hyperfuction,
salicylate intoxication and with excessive infusion of isotonic saline or extremely high dietary intake of
salt. Hyperchloremia acidosis may be a sign of severe renal tubular pathology. Chloride is decreased in
overhydration, chronic respiratory acidosis, salt-losing nephritis, metabolic alkalosis, congestive heart
failure, Addisonian crisis, certain types of metabolic acidosis, persistent gastric secretion and prolonged
vomiting, aldosteronism, bromide intoxication, SIADH, and conditions associated with expansion of
extracellular fluid volume.
Useful For: Chloride may be useful in the evaluation of water, electrolyte and acid-base status.
Interpretation: In normal individuals, serum chloride values vary little during the day, although there
is a slight decrease after meals due to the diversion of Cl to the production of gastric juice.
Reference Values:
1-17 years: 102-112 mmol/L
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