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Chloride

Also known as: CL

Why do you need to get tested for the chloride blood test?

The doctor ordered the test to assess and identify any electrolyte imbalance.

When do you need to get tested?

The chloride blood test is taken if your health care professional recommends it after deducing that your symptoms may be caused by an electrolyte imbalance or as part of a standard electrolyte panel.

What kind of sample is required for the chloride blood test?

The chloride blood test is a blood or urine test. A blood sample is taken from a vein in the arm. It can be taken randomly or as a 24-hour urine sample. The sample must be collected in a clean container.

Do you need to prepare for the test?

There is no preparation needed for the test.

What is being tested in the Chloride Test?

Chloride is a negatively charged electrolyte that controls and modulates the amount of fluid and the acid-base balance present within the body by working alongside other electrolytes like potassium, sodium, and bicarbonate. Chloride is found in all body fluids and is highly concentrated in the blood and fluids outside of the body’s cells. Chloride and Sodium levels generally have a direct correlation, with levels of chloride rising when there are high sodium levels and decreasing when there is a decrease in sodium levels. However, in cases of acid-base imbalance, chloride levels in the blood change in isolation as chloride acts as a buffer by sustaining electrical neutrality at the cellular level by going in and out of the cells when required. Chloride is extracted by the body from food and table salt, which is a combination of sodium and chloride ions. The digestive tract absorbs the required amount of chloride, and the rest is excreted out through urine. Blood levels remain stable except for a modest drop which occurs after meals as the stomach uses chloride to produce acid for digestion. The test gauges the level of chloride in the blood and/or urine.

How is the test used?

The blood test helps identify atypical levels of chloride. The test is commonly administered along with other electrolytes to check for various different conditions. The tests can assist in finding the etiology of symptoms such as prolonged vomiting, diarrhea, weakness, and difficulty breathing (respiratory distress). In case of an electrolyte imbalance, the cause for the imbalance is sought and treated. Electrolyte tests are also used to track the efficiency of the treatment plan. If an acid-base imbalance is probable, tests for blood gases are recommended to assess the cause and intensity of the imbalance. Urine chloride tests which show the levels of chloride present in urine, help identify whether the cause of alkalosis (too much base) is high levels of hormones like cortisol or aldosterone that impact electrolyte elimination or loss of salt (in cases of dehydration, vomiting, or use of diuretics, where urine chloride would be very low)

When is the test ordered?

Blood chloride is never independently administered or recommended. It is requested as part of an electrolyte panel, a basic metabolic panel, or a comprehensive metabolic panel. A chloride blood test is ordered when the healthcare professional suspects acidosis or alkalosis or when the patient has an acute condition showing the following symptoms:

Prolonged vomiting and/or diarrhea
Weakness, fatigue
Difficulty breathing (respiratory distress)

Electrolyte tests may be regularly administered if you have conditions such as high blood pressure (hypertension), heart failure, liver or kidney disease or if you are taking medication that leads to electrolyte imbalance. A urine chloride blood test is ordered along with a blood or urine sodium test to assess the reason for low or high blood chloride levels. The blood sodium levels and chloride levels are compared to check if they are correlated or not to check for acid-base imbalance, and to develop a proper treatment plan.

What does the test result mean?

Chloride tests are not ordered independently and are not interpreted in isolation. Other blood tests and electrolyte tests are ordered and interpreted alongside. High or low chloride concentrations can result from a variety of conditions. Elevated levels of blood chloride are known as hyperchloremia. An increased level of blood chloride (called hyperchloremia) usually suggests dehydration. However, chloride levels also rise due to conditions that cause increased blood sodium, for example, Cushing syndrome or kidney disease. High blood chloride is also caused by the loss of too much base from the body, which produces metabolic acidosis and, in the case of hyperventilation, leads to respiratory alkalosis. A drop in levels of blood chloride, which is also known as hypochloremia, can occur because of any condition that leads to a decline in blood sodium levels. It can occur along with congestive heart failure, diabetic ketoacidosis, aldosterone deficiency, prolonged vomiting or gastric suction, Addison disease, emphysema, or other chronic lung diseases that cause respiratory acidosis, and with loss of acid from the body (also known as metabolic alkalosis). A rise in urine chloride concentration in the urine suggests dehydration, starvation, Addison disease, or high consumption of salt. A reduction in urine chloride concentration is often found in patients with Cushing syndrome, primary aldosteronism, congestive heart failure, malabsorption syndrome, and diarrhea.

Related Tests: Sodium test, Potassium test, Bicarbonate (Total CO2), Electrolytes and Anion Gap, Comprehensive Metabolic Panel, (CMP), Basic Metabolic Panel (BMP blood test), Blood Gases

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