Chloride: the queen of electrolytes?

Area of Science:

• Biochemistry
• Physiology
• Clinical Medicine

Background:

• Ion channel diseases (channelopathies) are well-documented.
• Information on chloride's broader physiological roles, beyond channelopathies, is fragmented in medical literature.
• Textbooks often lack dedicated sections on hypochloremia or hyperchloremia.

Purpose of the Study:

• To systematically review the comprehensive function of chloride in human physiology.
• To consolidate scattered information on chloride's role in health and disease.
• To highlight chloride's significance in acid-base balance and metabolic disorders.

Main Methods:

• Systematic literature search using keywords like "chloride," "acid-base," "metabolic acidosis/alkalosis," and "anion gap."
• Inclusion of data from MEDLINE, PubMed, and relevant article references.
• Evaluation of internal medicine, critical care, nephrology, and gastroenterology textbooks.

Main Results:

• Chloride is the second most abundant serum electrolyte after sodium.
• It plays a critical role in fluid regulation, electrolyte balance, and maintaining electrical neutrality.
• Abnormal chloride levels often indicate serious underlying metabolic disturbances like acidosis or alkalosis.

Conclusions:

• Chloride is indispensable for assessing acid-base status and various pathological conditions.
• Diagnostic tests for numerous clinical situations involve chloride measurement (sweat, serum, urine, feces).
• Disruptions in chloride channel function can lead to diverse organ-specific disorders.