Biomarkers · Electrolytes & Minerals

Serum Chloride

Higher values go with lower risk of death. Not measured in our NHANES panel. The curve is drawn from the published study (source below).

Serum Chloride and risk of death

Published curve higher than the NHANES fitNHANES fit higher

Risk of death relative to the curve's reference value, drawn from the published study (source below).

Published risk of death0.77×highest (>=105.1) vs lowest (<=101.2 mmol/L) quartile of serum chloride (protective form… (95% CI 0.65–0.90) · NHANES 1999-2018 US adults linked to NDI through 2019

Serum Chloride by age and sex

Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.

The percentiles as a table

Each row is one sex and age band: the values below which 5%, 25%, 50%, 75% and 95% of people fall (mmol/L), from the survey named in the row. Not a reference range or a target.
Sex	Age	5th	25th	Median	75th	95th	n	Cycle / source
All	20-39	97.0	100	101	103	105	1,431	NHANES 2017-2018
All	40-59	96.0	99.0	101	103	105	1,548	NHANES 2017-2018
All	60+	95.0	99.0	101	103	105	1,891	NHANES 2017-2018
All	all	97.0	99.0	101	103	105	4,870	NHANES 2017-2018
Men	20-39	97.0	99.0	101	102	104	684	NHANES 2017-2018
Men	40-59	96.0	99.0	101	102	106	723	NHANES 2017-2018
Men	60+	95.0	99.0	101	103	105	958	NHANES 2017-2018
Men	all	96.0	99.0	101	102	105	2,365	NHANES 2017-2018
Women	20-39	98.0	100	102	103	105	747	NHANES 2017-2018
Women	40-59	97.0	99.0	101	103	105	825	NHANES 2017-2018
Women	60+	95.1	99.0	101	103	106	933	NHANES 2017-2018
Women	all	97.0	100	101	103	105	2,505	NHANES 2017-2018

What studies found when this marker was changed

They describe what happened in those study groups, not a recommendation. See all catalogued interventions.

Measured changes in Serum Chloride, study by study

4 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.

Each row is one study: what was changed, the effect it reported on this marker, and the source.
Type	Intervention	Reported effect	Evidence	Source
clinical	Perioperative balanced crystalloid solutions instead of normal saline during kidney transplant surgery (15 RCTs)	Postoperative serum chloride lower with balanced crystalloids vs normal saline (MD: - 7.31, 95% CI [- 10.58, - 3.77]); delayed graft function RR: 0.78	meta-analysis	Imran M, et al. Int Urol Nephrol. 2024. Perioperative balanced crystalloids…
clinical	Non-buffered crystalloid (e.g. 0.9% saline) instead of buffered fluid for perioperative volume replacement in adult surgery	Serum chloride 6.77 mmol/L (95% CI 3.38-10.17) higher immediately after surgery with non-buffered fluid; 8.48 mmol/L (1.08-15.88) higher on day 1	meta-analysis	Bampoe S, et al. Cochrane Database Syst Rev. 2017. Perioperative administration…
clinical	Resuscitation with balanced electrolyte solution instead of normal saline in adults with diabetic ketoacidosis	Post-resuscitation chloride 105 mmol/L (95% CI = 103-108) with balanced solution vs 111 mmol/L (95% CI = 110-112) with saline (P ≤ .001)	RCT	Mahler SA, et al. Am J Emerg Med. 2011. Resuscitation with balanced electrolyte…
diet	Adding 51 mmol/day (about 3 g) sodium chloride to the usual diet for 4 days in healthy postmenopausal women	Serum chloride +1.5 mmol/L with 51 mmol/day NaCl (p<0.05); 102 mmol/day raised it further	RCT	Zarkadas M, et al. Am J Clin Nutr. 1989. Sodium chloride supplementation and…

Things that worsen it

Each row is one study: what was changed, the effect it reported on this marker, and the source.
Type	Condition or exposure	Reported effect	Evidence	Source
pharmacologic	High-dose intravenous furosemide infusion (240 mg/day) for 4 days in patients admitted with heart failure	Serum chloride fell 7 mmol/L (IQR 2-10) from baseline after 4 days of high-dose IV furosemide; n=23	RCT	Cuthbert JJ, et al. Clin Res Cardiol. 2026;115(9):1675-1685.

Sources

Risk curve: Hou X 2023 (PMID 37955964): all-cause HR 0.77 (0.65-0.9) highest (>=105.1) vs lowest (<=101.2 mmol/L) quartile of serum chloride (protective form as reported; L-shaped). Scaled to published population values.
Hou X, Xu W, Zhang C, Song Z, Zhu M, Guo Q, Wang J. L-Shaped Association of Serum Chloride Level With All-Cause and Cause-Specific Mortality in American Adults: Population-Based Prospective Cohort Study. JMIR Public Health Surveill. 2023;9:e49291.

Map Serum Chloride against another biomarker.

Map Serum Chloride against another marker