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Other causes [citation needed] Ingestion of ammonium chloride, hydrochloric acid, or other acidifying salts; The treatment and recovery phases of diabetic ketoacidosis; Volume resuscitation with 0.9% normal saline provides a chloride load, so that infusing more than 3–4L can cause acidosis; Hyperalimentation (i.e., total parenteral nutrition)
Hyperchloremia is an electrolyte disturbance in which there is an elevated level of chloride ions in the blood. [1] The normal serum range for chloride is 96 to 106 mEq/L, [2] therefore chloride levels at or above 110 mEq/L usually indicate kidney dysfunction as it is a regulator of chloride concentration. [3]
The second is low total body water with normal body sodium. This can be caused by diabetes insipidus , renal disease, hypothalamic dysfunction , sickle cell disease , and certain drugs. [ 3 ] The third is increased total body sodium which is caused by increased ingestion, Conn's syndrome , or Cushing's syndrome .
Hyperparathyroidism – can cause hyperchloremia and increase renal bicarbonate loss, which may result in a normal anion gap metabolic acidosis. Patients with hyperparathyroidism may have a lower than normal pH, slightly decreased PaCO2 due to respiratory compensation, a decreased bicarbonate level, and a normal anion gap. [3]
The most common cause of ketoacidosis is a deficiency of insulin in type 1 diabetes or late-stage type 2 diabetes. This is called diabetic ketoacidosis and is characterized by hyperglycemia, dehydration and metabolic acidosis. Other electrolyte disturbances such as hyperkalemia and hyponatremia may also be present.
A normal anion gap acidosis (NAGMA) has more to do with a change in [Cl −] or [HCO − 3] concentrations. So the AG doesn't change; but to maintain electrical equilibrium, if [Cl −] goes up, [HCO − 3] must come down. Hence, hyperchloremia always causes a metabolic acidosis as [HCO − 3] must fall; alternatively, if the [HCO − 3] rises ...
High anion gap metabolic acidosis is a form of metabolic acidosis characterized by a high anion gap (a medical value based on the concentrations of ions in a patient's serum). Metabolic acidosis occurs when the body produces too much acid, or when the kidneys are not removing enough acid from the body. Several types of metabolic acidosis occur ...
Metabolic alkalosis is an acid-base disorder in which the pH of tissue is elevated beyond the normal range (7.35–7.45). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate (HCO − 3), or alternatively a direct result of increased bicarbonate concentrations.