CHLORIDE

GROUP 11 PRESANTATION
MOLECULAR STRUCTURE OF
CHLORIDE
• Chloride is a negatively charged ion(anion) formed when a chlorine
atom gain an extra electron or when a compound such as hydrogen
chloride is dissolved in water or other polar solvents
• Molecular weight of 35.5 g/mol
• A chloride ion is much larger than a chlorine atom,167 and 99
respectively
• The ion is colorless an diamagnetic
• Many forms of chloride salts are soluble or slightly soluble in water
including AgCl,PbCl2,HgCl
MAIN SOURCES OF CHLORIDE
• Naturally we can find chloride in sea water, sea water contains about 1.94% of
chloride
• Some minerals are sources of chloride include chlorides of sodium(halite or
NaCl), potassium (sylvite or KCl), and magnesium (bischofite), hydrated MgCl2.).
• It's easy to find chloride in foods, so deficiency is rare.
• Basically you consume chloride every time you add salt to your foods or when you
eat foods that are made with salt. Salt substitutes often use chloride too
• In addition to salt, many vegetables such as celery, tomatoes, and seaweeds are
good sources of chloride so deficiency is rare
• There's no reason to take chloride as a dietary supplement, the foods you eat are
more than sufficient.
ABSORPTION OF CHLORIDE IN GIT
• Takes place in the small intestine and large intestine.
• Mechanism involved in absorption
a) paracellular (passive) pathway
b)Electroneutral pathway ( involves Na+/H+ and Cl-/HCO3-
c) HCO3- dependent Cl- absorption
• When chloride exists as a potassium salt, it is also well absorbed. Other mineral salts, such as
magnesium chloride, are not absorbed as well, but bioavailability still remains high.
• Absorption of sodium in the small intestine plays an important role in the absorption of chloride,
amino acids, glucose, and water.
• Similar mechanisms are involved in the reabsorption of these nutrients after they have been
filtered from the blood by the kidneys. Chloride, in the form of hydrochloric acid (HCl), is also an
important component of gastric juice, which aids the digestion and absorption of many nutrients
Factors might enhance chloride absorption
• Other minerals
• Food intake
• Acidic environment of GIT
Factors might block chloride absorption
• Diuretics drugs example hydrochlorothiazide and Lasix
Note that 90% of chloride is lost through urine
• Competition with other minerals
EXCESSIVE AND DEFICIENCY OF
CHLORIDE IN PLASMA
• An excess of chloride in the body is called hyperchloremia and the
opposite effect is called hypochloremia.
• Chloride can be measured from the blood or from urine.
• Chloride plasma levels are an indication that a patient is probably
facing metabolic acidosis
• There are many kinds of metabolic acidosis and all of these are
sometimes asymptomatic but cannot be tolerated by our body when
swings are too radical.
Hyperchloremia
Hyperchloremia
• is an electrolyte disturbance in which there is an elevated level of the chloride ions in the
blood. The normal serum range for chloride is 98 to 107 mEq/L, therefore chloride levels
at or above 110 mEq/L usually indicate kidney dysfunction as it is a regulator of chloride
concentration.
• there are no specific symptoms of hyperchloremia, however, it can be influenced by
multiple abnormalities that cause a loss of electrolyte-free fluid, loss of hypotonic fluid,
or increased administration of sodium chloride. These abnormalities are caused by
• diarrhea,
• vomiting,
• increased sodium chloride intake,
• Renal dysfunction,
• Diuretic use, and
• Diabetes.
Facts on hyperchloremia:
• People with hyperchloremia have too much chloride in their
bloodstream, often due to changes in the body’s fluid levels.
• People undergoing chemotherapy have many risk factors for
hyperchloremia.
People undergoing chemotherapy may become nauseated or vomit
leading to dehydration that causes hyperchloremia.
• Chemotherapy can also damage the kidneys, harming their ability to
maintain the body’s balance of electrolytes. People taking chemotherapy
drugs that harm the kidneys may need regular electrolyte tests.
• Treatment for hyperchloremia depends on the cause.
• It is not always possible to prevent hyperchloremia.
• Symptoms
• When chloride levels are moderately high, a person may not notice any
symptoms. Long-term hyperchloremia, however, can cause a range of
symptoms. Those include:
• fluid retention
• high blood pressure
• muscle weakness, spasms, or twitches
• irregular heart rate
• confusion, difficulty concentrating, and personality changes
• numbness or tingling
• seizures and convulsions
• The severity of symptoms depends on how high
chloride levels are, how long they have remained that
high, and individual factors such as:
i. health
ii.nutritional status
iii.use of various medications
• The symptoms of hyperchloremia and electrolyte
imbalances are so general that it is impossible to
diagnose this syndrome based on symptoms alone.
People should not self-diagnose.
 CAUSES
•In children and adults, causes of hyperchloremia include:
•Gastrointestinal problems, such as vomiting or diarrhea. These issues can cause
dehydration.
•A high fever that causes sweating and dehydration.
•Dehydration due to medications, intense exercise, heat exposure, or not
drinking enough fluids.
•High sodium levels in the blood. Chloride tends to rise when sodium does.
•Too much salt intake. Chloride is an ingredient in sodium chloride, which is
table salt.
•Diabetes insipidus, which causes the kidneys to pass large amounts of fluid.
•Some medications, particularly hormones, diuretics, and corticosteroids, such
as hydrocortisone.
•Starvation due to eating disorders, severe malnourishment, or problems
absorbing nutrients from food.
•Diuretics
• In most cases, a diagnosis of hyperchloremia will require additional testing to uncover the
cause.
• Blood work may reveal a problem with the kidneys or liver. People should also provide their
doctors with details about their diet, especially if they consume large quantities of salt.
• Because some medications can alter chloride levels, it is essential that people tell their
doctor about all the medicines they are taking, including herbal supplements and over-the-
counter drugs.
• It may be necessary to address an underlying medical condition, such as liver cirrhosis, first.
People who have problems with their endocrine system — a group of glands that produce
hormones — may require hormone treatments or a consultation with an endocrinologist.
Some treatment options include:
• taking medications to prevent nausea, vomiting, or diarrhea
• changing drugs if they are a factor in the electrolyte imbalance
• drinking 2–3 quarts of fluid every day
• receiving intravenous fluids
HYPO
Hypochloremia
• is an electrolyte disturbance in which there is an abnormally low level of the
chloride ion in the blood. The normal serum range for chloride is 97 to 107 mEq/L.
It rarely occurs in the absence of other abnormalities. It is sometimes associated
with hypoventilation. It can be associated with chronic respiratory acidosis. If it
occurs together with metabolic alkalosis it is often due to vomiting. It is usually the
result of hyponatremia or elevated bicarbonate concentration. It occurs in cystic
fibrosis

• Hypochloremia occurs when there’s a low level of chloride in your body. It can be
caused by fluid loss through nausea or vomiting or by existing conditions, diseases,
or medications
What causes hypochloremia?
• Since the levels of electrolytes in your blood are regulated by your kidneys,
an electrolyte imbalance such as hypochloremia may be caused by a
problem with your kidneys.
Learn the basics of kidney health and kidney disease.
• Hypochloremia can also be caused by any of the following conditions:
• congestive heart failure
• prolonged diarrhea or vomiting
• metabolic alkalosis, when your blood pH is higher than normal
• Certain types of drugs, such as laxatives(bisacodyl), diuretics(furosemide),
corticosteroids, and bicarbonates, can also cause hypochloremia.
What are the symptoms of hypochloremia?
• You often won’t notice symptoms of hypochloremia. Instead, you may
have symptoms of other electrolyte imbalances or from a condition
that’s causing hypochloremia.
• Symptoms include:
• fluid loss
• dehydration
• weakness or fatigue
• difficulty breathing
• diarrhea or vomiting, caused by fluid loss
treatment
• If hypochloremia is due to a medication or drug that you’re taking,
then your doctor may adjust the dosage, if possible. If your
hypochloremia is due to problems with your kidneys or an endocrine
disorder, your doctor may refer you to a specialist.
• intravenous (IV) fluids, such as normal saline solution, to restore
electrolytes to normal levels.
• If hypochloremia is mild, then it can sometimes be corrected by an
adjustment to diet. This could be as simple as consuming more
sodium chloride (salt)
FUNCTIONS OF CHLORIDE
What is the function of chloride in the body?
• Chloride is an electrolyte. It is a negatively charged ion that works
with other electrolytes, such as potassium, sodium, and bicarbonate,
to help regulate the amount of fluid in the body and maintain the
acid-base balance.
• Chloride is the predominant extracellular anion and it is a major
contributor to the osmotic pressure gradient between the
intracellular fluid (ICF) and extracellular fluid (ECF).
FUNCTIONS OF CHLORIDE
• Chloride maintains proper hydration and functions to balance the
cations in the ECF to keep the electrical neutrality of this fluid. The
paths of secretion and reabsorption of chloride ions in the renal
system follow the paths of sodium ions
• A chloride ion is a structural component of some proteins, e.g., it is
present in the amylase enzyme.
• Transmitting nerve impulse
• Regulating fluid in and out of the cell e.g cystic fibrosis
• Enhances CO2 carrying capacity of RBC’s ( chloride shift)
Role of Kidney in Chloride balance
• The kidney help maintain electrolyte concentration by filtering electrolytes
and water from blood and excreting any excess into the urine, therefore the
kidney help maintain a balance between daily consumption and excretion of
electrolyte and water
• The excretion of ions occurs mainly through the kidneys, with lesser amounts
of ions being lost in sweat and in feces. In addition, excessive sweating may
cause a significant loss, especially of the anion chloride. Severe vomiting or
diarrhea will also cause a loss of chloride and bicarbonate ions
• If the balance is disturbed the disorder my develop.
• Adjustments in the respiratory and renal functions allow the body to regulate
the levels of these ions in the extracellular fluid (ECF).
Advice
Dietary Reference Intakes
• 1 to 3 years: 1.5 grams per day
4 to 8 years: 1.9 grams per day
9 to 50 years: 2.3 grams per day
51 to 70 years: 2.0 grams per day
71+ years: 1.8 grams per day
Women who are pregnant or breastfeeding: 2.3 grams per day