Chloride (Cl-) [Serum/Urine]

Clinical definition of the Chloride test
Chloride is an electrolyte that works with other electrolytes, such as potassium, sodium and bicarbonate (total CO2) to help maintain and regulate the amount of fluid (water and electrolyte) balance in the body, stimulate muscle contraction and maintain a stable acid-base balance in blood and tissue cells.
If there's a large loss of chloride, the blood may become more acidic and prevent the occurrence of certain chemical reactions in the body. These reactions are necessary to keep the body working properly. Chloride acts as a buffer and helps to maintain electrical neutrality at the cellular level by moving into or out of the cells as needed.

Why is the Chloride test done?
This test measures the amount of chloride in the blood or urine. A chloride test may also be done in the following cases:-

  • As a routine medical exam as part of an electrolyte or metabolic panel
  • To help evaluate an electrolyte imbalance
  • At regular intervals to check for the effect of a medication for electrolylte imbalance
  • For a suspected case of metabolic acidosis (caused by uncontrolled diabetes) or alkalosis (caused by excess vomiting).
  • To find the cause of loss of salt in cases of dehydration, vomiting or the use of diuretics, where urine chloride would become very low.
  • To assess the excess of certain hormones such as cortisol or aldosterone, where the urine chloride would become high
  • Along with sodium to monitor persons put on a low-salt diet

What are the common signs/symptoms when the Chloride test is done?

  • Prolonged vomiting
  • Prolonged diarrhea
  • Weakness
  • Fatigue
  • Respiratory distress

Who should do the Chloride test (Target population)?
Persons showing the above signs & symptoms or those having an electrolyte imbalance and may be on medication for it.

What should I do before the Chlorides test?

Specimen type

Specimen collection procedure

Preparatory instructions before the test *

Serum (Blood Sample)












(Collection of blood from a vein, usually from the arm)


Random Mid-Stream Urine Sample

(not at the beginning and not at the end) should be collected. Care must be taken to clean the genitals well before collection.

Follow these steps to get the sample

Initial or the first few drops of the urine should be discarded in the toilet.

Mid-stream urine sample should be collected in the sterile container provided.

Latter part or the end of the urine should not be collected.

Cap the container. Keep it in the refrigerator or a cool place during the collection period.


24-hour urine sample

Care must be taken to clean the genitals well before collection.

Follow these steps to get the sample

Day 1- The first morning urine sample on Day 1 must not be collected i.e. bladder must be emptied for the first time.

Note down the exact time of discarding the 1st urine sample.

All urine for the next 24 hours should be collected in the special container provided.

Day 2- collect the first morning urine of Day 2 into the same container, at the same time or within 10 minutes as that noted on the morning of Day 1.

Cap the container. Keep it in the refrigerator or a cool place during the collection period.

No Fasting Required.


No special preparations required.

*Subjects suffering from any illness or on oral or injectable medications are advised to consult their physician prior to requesting any tests or procedures.

How do I interpret my Chloride test results?

Reference Range*




98 to 107 mmol/L


98 to 107 mmol/L

0 - 7 days 

97 - 108 mmol/l

7 - 31 days 

97 - 108 mmol/l

1 - 6 months 

97 - 108 mmol/l

6 months - 1 yr

97 - 106 mmol/l

> 1 yr

97 - 107 mmol/l

24 hr Urine


110 to 250 mmol/24 hrs

Above 60 yrs

95 to 195 mEq/24 hrs

Inference: Increased levels of blood chloride (called hyperchloremia) usually indicate dehydration, but can also occur with other problems that cause high blood sodium, such as Cushing's syndrome or kidney disease. Hyperchloremia also occurs when too much base is lost from the body (producing metabolic acidosis) or when a person hyperventilates (causing respiratory alkalosis).

Decreased levels of blood chloride (called hypochloremia) occur with any disorder that causes low blood sodium. Hypochloremia also occurs with prolonged vomiting or gastric suction, emphysema or other chronic lung diseases (causing respiratory acidosis), and with loss of acid from the body (called metabolic alkalosis).

‘*A Reference range is a set of values which helps the healthcare professional to interpret a medical test. It may vary with age, gender, and other factors. Reference ranges may also vary between labs, in value & units depending on instruments used and method of establishment of reference ranges’

Diseases/conditions related to the Chloride test

  • Hyperchloremia
  • Cushing's syndrome or kidney disease
  • Gastric suction, emphysema or other chronic lung diseases
  • Metabolic acidosis
  • Metabolic alkalosis

Other tests related to the Chloride test

  • Sodium
  • Potassium
  • Bicarbonate (total CO2)
  • Electrolyte panel
  • Comprehensive Metabolic Panel (CMP)
  • Basic Metabolic Panel (BMP)

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Chloride (Serum)