Chloride is an electrolyte that is important for various bodily processes. Its homeostasis is interrelated with sodium and potassium. Chloride levels in the plasma and cerebrospinal fluid are tightly regulated to maintain membrane equilibriums. Chloride is primarily excreted through urine in parallel with sodium levels. Conditions like dehydration, Cushing's syndrome, and renal tubular acidosis can cause hyperchloremia, while excessive vomiting, sweating, and Addison's disease can result in hypochloremia. The cystic fibrosis transmembrane conductance receptor chloride channel is involved in the pathogenesis of cystic fibrosis.

1. WELCOME
SURAMYA BABU

2. CHLORIDE

3. CHLORIDE
• Intake, output and metabolism of sodium and
chloride run in parallel.
• The homeostasis of sodium, potassium, and
chloride are interrelated.
• Chloride is important in the formation of
hydrochloric acid in gastric juice.
• Chloride ions are also involved in chloride
shift.

4. • Chloride concentration in plasma is
96-106mEq/L.
• In CSF, it is about 125mEq/L.
• Chloride concentration in CSF is higher than
any body fluids. Since CSF protein content is
low.
• Chloride is increased to maintain Donnan
membrane equilibrium.

5. • Excretion of chloride is through urine, and is
parallel to sodium.
• Renal threshold for chloride is about
110mEq/L.
• Daily excretion of chloride is about 5-8 g/day.

6. • In chloride responsive conditions, urinary
chloride is less than 10 mmol/L.

7. Hyperchloremia
• Is seen in
• Dehydration
• Cushing’ syndrome. Mineralocorticoids cause
increased reabsorption from kidney tubules.
• Severe diarrhoea leads to loss of bicarbonate
and compensatory retention of chloride.
• Renal tubular acidosis.

8. Hypochloremia
• Excessive vomiting. HCl is lost, so plasma
chloride is lowered. There will be
compensatory increase in plasma bicarbonate.
This is called hypochloremic alkalosis.
• Excessive sweating.
• In Addison’s disease, aldosterone is
diminished, renal tubular reabsorption of
chloride is decreased , and more chloride is
excreted.

9. Chloride channels
• The CFTR (Cystic Fibrosis Transmembrane
Conductance Receptor) chloride conducting
channel is involved in cystic fibrosis.
• In Cystic Fibrosis, a point mutation in the CFTR
gene results in defective chloride transport.
• So water moves out from lungs and pancreas.

10. • This is responsible for the production of
abnormally thick mucous.
• This will lead to infection and progressive
damage and death at a young age.

11. REGULATION MECHANISMS OF ELECTROLYTES
SODIUM ( Na⁺) Aldosterone, antidiuretic hormone(ADH)-water regulation
Atrial natriuretic peptide (ANP)
Renal reabsorption
Renal excretion
POTASSIUM (K⁺) intestinal absorption Aldosterone
Glucocorticoids (lesser degree)
Renal reabsorption
Renal excretion
CALCIUM (Ca⁺⁺) Parathyroid hormone
Calcitonin
Magnesium (helps in calcium metabolism and intestinal
absorption)
Intestinal absorption
Renal absorption
Renal excretion
MAGNESIUM (Mg⁺⁺) Intestinal absorption
Renal reabsorption
Renal excretion
CHLORIDE (Cl⁻) Intestinal absorption
Renal reabsorption
Renal excretion