Chloride

CPT: 82435
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Test Details

Use

Evaluate electrolytes, acid-base balance, water balance. Chloride generally increases and decreases with plasma or serum sodium.

Chloride is increased in dehydration, with ammonium chloride administration, with renal tubular acidosis (hyperchloremic metabolic acidosis) and with excessive infusion of normal saline. Differential diagnosis of acidemias and alkalemias. Chloride is higher in hyperparathyroidism than in some of the other causes of hypercalcemia, but a great deal of overlap exists.

Chloride is decreased with overhydration, congestive failure, syndrome of inappropriate secretion of ADH, vomiting, gastric suction, chronic respiratory acidosis, Addison disease, salt-losing nephritis, burns, metabolic alkalosis, and in some instances of diuretic therapy.

Methodology

Ion-selective electrode (ISE)

Reference Interval

96−106 mmol/L

Additional Information

Like other electrolytes, chloride cannot be interpreted without clinical knowledge of the patient. A diagnostic approach to the evaluation of hyperchloremic metabolic acidosis includes use of the urinary anion gap in conjunction with measurement of plasma potassium and urinary pH.1

Specimen Requirements

Specimen

Serum (preferred) or plasma

Volume

1 mL

Minimum Volume

0.5 mL

Container

Red-top tube, gel-barrier tube, or green-top (lithium heparin) tube

Collection

Separate serum or plasma from cells within 45 minutes of collection.

Storage Instructions

Maintain specimen at room temperature.

Stability Requirements

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Causes for Rejection

Improper labeling

Clinical Information

Footnotes

1. Batlle DC, Hizon M, Cohen E, Gutterman C, Gupta R. The use of the urinary anion gap in the diagnosis of hyperchloremic metabolic acidosis. N Engl J Med. 1988 Mar 10; 318(10):594-599. 3344005

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
001206 Chloride, Serum 2075-0 001206 Chloride, Serum mmol/L 2075-0

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