Gastrointestinal causes •
Gastric fluid loss – loss of hydrochloric acid from the stomach due to severe
vomiting or
nasogastric suction tube.
Renal causes •
Diuretic therapy –
Thiazide diuretics and
loop diuretics like
furosemide inhibit chloride reabsorption causing hypochloremia and metabolic alkalosis. Thiazides block
NCC and furosemide blocks
NKCC2. •
Chronic respiratory acidosis – Compensatory reabsorption of bicarbonate in exchange for chloride. •
Bartter syndrome – Chloride wasting due to defective
NKCC2 Symptoms similar to loop diuretic therapy like furosemide. •
Gitelman syndrome – Chloride wasting due to defective
NCC. Symptoms similar to thiazide diuretic therapy.
Other causes •
Cystic fibrosis – Loss of chloride through excessive sweating due to defective chloride transport. •
Excessive bicarbonate administration – Can dilute serum chloride and shift acid-base balance. ==References==