Chloride: The Forgotten Ion
Year: 2025
Type: article
Abstract: Chloride (Cl-) is the most common anion in intracellular and extracellular fluid. It maintains acid-base balance, plasma oncotic pressure, osmolarity, the resting action potential, and carbon dioxide transport in erythrocytes. It keeps serum concentrations within a very narrow range through hormonal control by the renin-angiotensin-aldosterone system and cortisol. In practice, we have rarely asked ourselves how to calculate the Cl- when we prescribing intravenous solutions to a patient, but we must remember that even a minor change in the Cl- concentration is enough to produce not only a profound alteration of the acid-base balance and thus adverse effects in practically any organ system, as explained by the Stewart model through the strong ion difference (SID), where the smaller the difference between cations and anions [(Na+, K+, Ca+ and Mg+) - (Cl- and lactate)], the higher the concentration of hydrogen ions [H+] and therefore hyperchloremic metabolic acidosis. The measured use of chloride solutions should guide medical conduct at the time of their administration.
Author: Oscar Miguel Oliva Meza-Hernández¹*, Elizabeth Cárdenas Anaya², Norma Alejandra Márquez Sáinz³, María Cristina Quevedo Villaseñor⁴, Héctor Luis Guillermo Macías Villa⁵, Cecilia Ramírez Angulo⁶, Alma Paola Alonso Bringas⁷
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W6911981301
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