Hypochloremia: What Is It and How Is It Treated

Hypochloremia is a condition where the body cannot excrete excess salt properly due to a lack of water in the blood. When there isn’t enough water in the blood, it causes high potassium levels. High potassium levels cause muscle cramps and other symptoms similar to those caused by high blood pressure or heart failure. [1]

The most common symptom of hypochloremia is fatigue. Other symptoms include nausea, vomiting, diarrhea, headache and weakness. These symptoms may occur even if the patient doesn’t have any signs of dehydration. [2]

In some cases hypochloremic patients develop kidney problems such as acute renal failure (ARF). ARF occurs when the kidneys don’t get enough fluid from their normal urine output. This results in a loss of fluids into the bloodstream causing a drop in blood pressure and sometimes death. [3]

Symptoms of hypochloremia include dizziness, confusion, fainting, sweating and shivering. If left untreated these symptoms can lead to coma or death. [4]

Hypochloremic patients are at risk for developing hypokalemia (low potassium) which can result in seizures and coma.[5][6]

Hyponatremia is a condition where the level of sodium in the blood becomes too low. There are two main types of hyponatremia, hypervolemic and hypotonic.

In hypervolemic hyponatremia, the blood has an excess amount of fluid and extra sodium. The body begins to swell due to excess fluid building up. This swelling can put pressure on the brain causing various neurological symptoms such as confusion, drowsiness and in severe cases, coma or death. Neurological symptoms can also be caused by the patient’s heart having to work harder to pump all the extra fluid throughout the body.


Patients suffering from hypotonic hyponatremia don’t have enough sodium in their blood. This causes the blood to become more water than sodium, which dilutes the blood. The brain begins taking in water causing it to swell. The brain is surrounded by a tight membrane that if swells can cause extreme pressure and death.

Swelling in other parts of the body can cause heart failure. Other symptoms may include muscle spasms and lack of energy. [8]

In both types of this condition, patients can experience the following symptoms: confusion, drowsiness, loss of energy, nausea and vomiting, decreased urination, tremor, seizures or convulsions, coma and in severe cases death.

Treatment of hyponatremia begins with getting the patient’s sodium level back to a safer range. This is done by either taking in extra sodium or letting the body release its own sodium through sweating. Typically intravenous fluids are used to flush out the extra fluid in the patient’s body. If this isn’t effective, the kidneys may be slowed down with medication to help get the excess fluid out of the body.


More severe cases may require surgery to release the pressure in the brain caused by fluid buildup. [10]

Hyponatremia is caused by over-hydration which can occur from drinking too much water or other fluids. This condition can also be caused by severely low sodium levels in the body including due to medical conditions such as kidney disease or adrenal gland problems.

Other causes of hyponatremia include the taking of certain medications such as diuretics, certain psychiatric drugs and some antidepressants. It can also be brought on by illnesses such as meningitis, Multiple Sclerosis, brain tumors and HIV. Pregnancy can also cause this condition. [11]

Hypovolemic hyponatremia is the most common type caused by over-hydration. It is often brought on by endurance sports where the participants are drinking large amounts of water. The following are other causes of hyponatremia:

Type Symptoms Overhydration Similar to those of hypochloremia but with signs of overhydration such as dry cracked lips, lethargy or fainting due to blood pressure being too low.

Sources & references used in this article:

Treatment of refractory congestive heart failure and normokalemic hypochloremic alkalosis with acetazolamide and spironolactone. by MI Khan – Canadian Medical Association Journal, 1980 – ncbi.nlm.nih.gov

Long-term combined treatment with thiazide and potassium citrate in nephrolithiasis does not lead to hypokalemia or hypochloremic metabolic alkalosis by CV Odvina, GM Preminger, JS Lindberg, OW Moe… – Kidney international, 2003 – Elsevier

Hypokaliemic, hypochloremic alkalosis in cushing’s syndrome. Observations on the effects of treatment with potassium chloride and testosterone by R TEABEAUT, FL ENGEL… – The Journal of Clinical …, 1950 – academic.oup.com

Treatment of hypochloremia with acetazolamide in an advanced heart failure patient and importance of monitoring urinary electrolytes by H Kataoka – Journal of cardiology cases, 2018 – Elsevier

Metabolic Studies of Patients with Cancer of the Gastro-Intestinal Tract: XVI. The Treatment of Hypochloremia Refractory to the Administration of Sodium Chloride … by I ARIEL, JC ABELS, GT PACK… – Journal of the American …, 1943 – jamanetwork.com

Intravenous infusion of hydrochloric acid for treatment of severe metabolic alkalosis by GM Abouna, PR Veazey, DB Terry – Surgery, 1974 – surgjournal.com

Efficacy of oral potassium chloride administration in treating lactating dairy cows with experimentally induced hypokalemia, hypochloremia, and alkalemia by PD Constable, MWH Hiew, S Tinkler… – Journal of dairy science, 2014 – Elsevier