Hyperchloremia in patients with chronic renal failure.

The electrolyte and acid base composition of steady state chronic renal failure patients were studied. A particular comparison was made between the group of hyperchloremic and normochloremic patients, matched for sex, age, serum creatinine concentration and the etiology of the disease. Hyperchloremia was constantly seen in any stage of the disease in hyperchloremic patients, and they were found to be more acidemic, with lower anion gap, than normochloremic patients. A greater degree of tubular dysfunction than glomerular dysfunction was considered as the cause of acidosis and hyperchloremia in any stage of the disease. Hyperchloremia could be an indication to initiate alkali therapy to protect against further loss of bone mineral and the progression of the disease itself.