Sodium And Chloride - Deficiency Test
The sodium and chloride test determines urine levels of sodium, the major extracellular cation, and of chloride, the major extracellular anion. Less significant than serum levels (and, consequently, performed less frequently), measurement of urine sodium and urine chloride concentrations is used to evaluate renal conservation of these two electrolytes and to confirm serum sodium and chloride values.
In the body, sodium and chloride help maintain osmotic pressure and water and acid-base balance. Normal ranges of sodium and chloride in the urine vary greatly with dietary salt intake and perspiration.
Procedure and posttest care
Normal urine sodium excretion ranges from 40 to 220 mEq/L/24 hours or 40 to 220 mmol/day in an adult; in a child, from 41 to 115 mEq/L/24 hours. Normal urine chloride excretion ranges from 140 to 250 mEq/L/24 hours in an adult; in children ages 6 to 10, from 15 to 40 mEq/L/24 hours; and in children ages to to 14, from 64 to 176 mEq/L/ 24 hours.
Usually, urine sodium and urine chloride levels are parallel, rising and falling in tandem. Abnormal levels of both minerals may indicate the need for more specific testing.
Elevated urine sodium levels may reflect increased salt intake, adrenal failure, salicylate toxicity, diabetic acidosis, salt-losing nephritis, and water-deficient dehydration.
Elevated urine chloride levels may result from water-deficient dehydration, salicylate toxicity, diabetic ketoacidosis, adrenocortical insufficiency (Addison's disease), or salt-losing renal disease. Decreased levels may result from excessive diaphoresis, heart failure, hypochloremic metabolic alkalosis, or prolonged vomiting or gastric suctioning.
To evaluate fluid-electrolyte imbalance, results must be correlated with findings of serum electrolyte studies.
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