The well-known clinical symptoms of CNDI are polydipsia, polyuria, hypernatremia and hyperchloraemia
- HES solutions for infusion are also contraindicated in dehydrated patients, hyperhydrated patients, patients with intracranial or cerebral haemorrhage, burn injuries, severe hyperkalaemia, hypernatraemia, hyperchloraemia
, congestive heart failure, organ transplant patients and patients with impaired hepatic function.
Hypochloraemia was present in 29.26% of cases, whereas hyperchloraemia
was present in 7.32% of cases.
The measurement of lactate, the product of anaerobic metabolism, and the surrogate base deficit (BD) are well-recognised markers of cellular hypoperfusion and the severity of shock,  although BD may also be elevated under aerobic conditions such as acute kidney injury or hyperchloraemia
, both of which commonly occur after major trauma as a result of renal hypoperfusion and excessive saline-containing resuscitation fluids.
The influence of hyperchloraemia
on acid base interpretation in diabetic ketoacidosis.
As chloride regulates renal vascular resistance, the hyperchloraemia
caused by 0.9% saline causes a reduction in glomerular filtration rate.
Impaired level of consciousness was defined as a Glasgow Coma Scale <15, hypernatraemia as uncorrected serum sodium >150 mmol/l, hypokalaemia as serum potassium <3.5 mmol/l, hyperkalaemia as serum potassium >5.5 mmol/l, hypochloraemia as serum chloride <94 mmol/l, and hyperchloraemia
as serum chloride >104 mol/l.