Hyperchloremia is when a person has too much chloride in their blood. Chloride is an electrolyte, and changes in electrolyte levels can be a sign of dehydration. In the long term, hyperchloremia can lead to fluid retention and other symptoms.

Electrolytes, including chloride, are electrically charged minerals that help control the amount of fluids in the body.

People can regain typical electrolyte levels with careful management of fluids and food and prompt treatment of any underlying conditions.

This article outlines what hyperchloremia is, including its symptoms and causes. It also examines how doctors diagnose and treat the condition and if a person can prevent it.

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Hyperchloremia is an electrolyte imbalance in which a person has high levels of chloride, or serum chloride anion, in the blood.

People usually consume chloride through food. This is because most chloride exists in the form of sodium chloride, or table salt. The gastrointestinal tract absorbs most of it, and the body expels the excess through the urine.

Along with sodium, chloride is important for maintaining the body’s water levels and acid-base balance.

Typically, hyperchloremia does not cause specific symptoms. However, chloride helps the body maintain its fluid balance. A person with a fluid imbalance may experience symptoms such as:

  • diarrhea
  • vomiting
  • fatigue
  • dehydration
  • weakness
  • difficulty breathing

The symptoms of hyperchloremia and electrolyte imbalances are so general that it is impossible to diagnose this syndrome based on symptoms alone. Additionally, a person may experience symptoms related to the underlying cause.

People should not self-diagnose. A simple blood test can detect hyperchloremia.

Hyperchloremia can result from an underlying condition, such as kidney disease. However, having chloride levels outside the typical range does not necessarily indicate a medical condition.

For example, certain medications or dehydration due to vomiting or diarrhea may affect a person’s chloride levels.

A 2020 systematic review lists some causes based on research from 2017:

increased chloride intakefluid therapy with high chloride solutions
loss of waterconditions or medications affecting the kidneys:
• diabetes
• diuretic medications
• a stage of kidney failure that increases urine output

other causes:
• fever
• diarrhea
• burns
• severe dehydration
• exercise, which can lead to dehydration
• hypermetabolism
absolute or relative increase in chloride tubular reabsorption rates• kidney failure
• renal tubular acidosis — a condition in which the kidneys are unable to remove acids from the blood
• acetazolamide — a treatment for glaucoma
• reconstructive surgery of the lower urinary tract

What is the relation to chemotherapy?

People undergoing chemotherapy may become nauseated or vomit, leading to dehydration that causes hyperchloremia.

Some types of chemotherapy can cause kidney problems, which may affect their ability to maintain the body’s balance of electrolytes. People taking chemotherapy drugs that harm the kidneys may need regular electrolyte tests.

As chemotherapy can weaken the body, people with hyperchloremia who are undergoing chemotherapy may experience more intense symptoms.

People should keep their doctor informed of any symptoms they experience, particularly if they suddenly worsen.

A doctor will order a blood test to diagnose hyperchloremia. They may request this test alongside a sodium test.

A doctor may consider a person to have high chloride levels if concentration levels increase over 107 millimoles per liter (mmol/L). However, this figure may vary depending on the reference limits of the testing laboratory.

Hyperchloremia treatment will depend on the underlying cause. For example:

  • Dehydration: A doctor will recommend getting and remaining hydrated.
  • Medications: A doctor may recommend stopping or changing medications if they are causing hyperchloremia.
  • Receiving too much saline: A doctor will stop giving a person saline solution until they have recovered.
  • Kidney problems: If a person has a condition affecting the kidneys, a doctor may refer them to a nephrologist for further diagnostics and treatment.

Without treatment, hyperchloremia can lead to complications in critically ill people, including kidney dysfunction and an increased risk of death.

Drinking enough fluid and avoiding excessive salt consumption can help prevent this electrolyte imbalance.

However, for people who are at risk of developing hyperchloremia, some strategies that may help include:

  • talking with a doctor about medications that can cause hyperchloremia
  • discussing options for reducing the effects of drugs that can cause hyperchloremia
  • eating a balanced diet and avoiding extreme food restrictions
  • taking medications exactly as a doctor prescribes

The following are commonly asked questions about hyperchloremia.

What does it mean if a person’s chloride is high?

High chloride levels can indicate an underlying medical condition, such as kidney disease. However, chloride levels outside of the typical range can develop due to dehydration, medication, vomiting, and diarrhea.

Does drinking water lower chloride levels?

If a person’s hyperchloremia is a result of dehydration, drinking water can help rebalance a person’s electrolyte levels.

What foods should I avoid if my chloride is high?

A person with high chloride levels may wish to avoid eating foods high in salt.

How do you treat hypochloremia?

Treating hypochloremia will depend on the underlying cause. A doctor may recommend intravenous saline to help restore electrolyte levels.

Hyperchloremia is when a person has high chloride levels in the blood. Chloride is an electrolyte that helps maintain the body’s fluid levels.

There are no specific symptoms of hyperchloremia. However, some symptoms of electrolyte imbalances include diarrhea, vomiting, fatigue, and dehydration.

Hyperchloremia can develop due to dehydration. It can also indicate an underlying medical condition, such as kidney disease. Treating the underlying cause of hyperchloremia can restore typical electrolyte levels.