Previous studies suggested that renal impairment was associated with hyperchloremic metabolic acidosis, which could be exacerbated by saline infusion [30, 31] and the acid-base changes that accompanied hyperchloremia might be related to the difference in the concentrations of strong cations (sodium and potassium), strong anions (chloride and lactic acid), and albumin. Here, ALB is linked to Hyperchloremia.