Hyperchloremia

Aka: Hyperchloremia, High Serum Chloride

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II. Pathophysiology

  1. Metabolic Acidosis with a normal Anion Gap

III. Causes

  1. Artifact (low Anion Gap)
  2. Metabolic and Endocrine
    1. Hyperparathyroidism
    2. Renal Tubular Acidosis
    3. Metabolic Acidosis
    4. Hypernatremia
  3. Gastrointestinal
    1. Dehydration
    2. Prolonged Diarrhea
    3. Loss of pancreatic secretion
    4. Ileal loops
    5. Ureteral colonic anastomosis
  4. Medications
    1. Bromide Intoxication
      1. Nervine
      2. Sominex
    2. Acetazolamide
      1. Carbonic anhydrase inhibition
    3. Boric Acid
    4. Triamterene
    5. Ammonium Chloride
    6. Excess IV Normal Saline

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