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Chloride Test - Urine

Last updated Nov. 27, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Chloride is an anion (negatively charged ion) that helps in regulating the body fluid amount and acid-base balance, along with sodium, potassium, and bicarbonate.

What are the other Names for this Test? (Equivalent Terms)

  • Urinary Chloride Test

What is Chloride Urine Test? (Background Information)

  • Chloride is an anion (negatively charged ion) that helps in regulating the body fluid amount and acid-base balance, along with sodium, potassium, and bicarbonate
  • It is found in all body fluids, but is present in higher concentrations outside of the cells
  • The body gets chloride through food; excess chloride is eliminated by the kidneys via urine
  • Whenever the physician suspects any disturbance in the acid-base balance, or any changes in body fluid levels or electrolytes (ions present in body fluids), or a condition called renal tubular acidosis, an Urinary Chloride Test is ordered

What are the Clinical Indications for performing the Chloride Urine Test?

Urinary Chloride levels (along with blood and urinary sodium) may be measured during:

  • Evaluation of any changes in the blood chloride levels, as can happen during any acid-base imbalances (brought on by conditions including prolonged vomiting, diarrhea, respiratory distress, drugs, and other diseases.)
  • If a physician suspects low blood potassium (hypokalemia), Urinary Chloride levels aid in identifying the cause
  • They also help in diagnosing a condition, called renal tubular acidosis - where the kidneys fail to normally acidify the urine, leading to accumulation of acid in the body

How is the Specimen Collected for Chloride Urine Test?

Sample required: Random urine sample, or a 24-hour urine sample

Process: The urine samples are collected into a container over a 24-hour period, while keeping the container refrigerated in between the collections.

Preparation required: None. Although, sometimes the physician may advise discontinuation of drugs, which are known to affect chloride levels, if deemed necessary.

What is the Significance of the Chloride Urine Test Result?

The normal range of values, called the reference range, may vary slightly amongst different laboratories. A common reference range for 24-hour Urinary Chloride is 110-250 milliequivalents per day (mEq/day).

Increased levels of Urinary Chloride may be produced by conditions, such as:

  • Consumption of increased amounts of salt
  • Addison disease
  • Salt loss in urine due to inflamed kidneys; a condition known as salt-wasting nephropathy
  • Passing increased amounts of urine (polyuria)

Decreased levels of Urinary Chloride may be caused by conditions, such as:

  • Consumption of decreased amounts of salt
  • Cushing syndrome
  • Conn syndrome
  • Vomiting, diarrhea, excess sweating, leading to loss of fluids from the body

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

Drugs that may increase Urinary Chloride levels include:

  • Diuretics
  • Corticosteroids

Drugs that may decrease Urinary Chloride levels include:

  • NSAIDs (non-steroidal anti-inflammatory drugs)
  • Acetazolamide

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider, the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

References and Information Sources used for the Article:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Nov. 11, 2013
Last updated: Nov. 27, 2018