Fluid Rentention

[WifeofDiaylsisPatient]

Hello All,

My husband is very good about watching his fluid intake.  About 3 weeks ago his feet started to swell, and now his toes and calves are also swollen, he's retaining too much fluid.  They are going to have him do dialysis for the next three days in a row, as when they try to take off excess fluid during a regular session, his blood pressure drops too much.  He does not over eat, in fact, he has probably lost 3-4 pounds over the last 6 weeks as his appetite has not been to good.  He avoids salt.  About 3 months ago, he went from 3.5 hours of treatment, to 3.25 hours, and the last two weeks he has been going 3.0 hours on treatment (doctors OK).  He typically has 1.0 to 1.5 kilos removed during treatment, whether it is a 3.5, 3.25, or 3.0 hour treatment.  Nothing has really changed, this is the amount he has been having taken off each time for the last 3-4 months and no issues, no swelling/fluid retention until now.  Any ideas why?

[jeannea]

Why? It could be that his kidney function is now worse than when he started dialysis. It could be he is not getting enough dialysis. It could also show that his heart is having a problem. If the three days of dialysis doesn't help, go see another doctor. Even your primary care doctor can help figure out if he needs to see a cardiologist. If at any point he gets worse - swelling gets significantly worse, has any trouble breathing, feels chest pains - please go to the ER.

[PrimeTimer]

Hello All,

My husband is very good about watching his fluid intake.  About 3 weeks ago his feet started to swell, and now his toes and calves are also swollen, he's retaining too much fluid.  They are going to have him do dialysis for the next three days in a row, as when they try to take off excess fluid during a regular session, his blood pressure drops too much.  He does not over eat, in fact, he has probably lost 3-4 pounds over the last 6 weeks as his appetite has not been to good.  He avoids salt.  About 3 months ago, he went from 3.5 hours of treatment, to 3.25 hours, and the last two weeks he has been going 3.0 hours on treatment (doctors OK).  He typically has 1.0 to 1.5 kilos removed during treatment, whether it is a 3.5, 3.25, or 3.0 hour treatment.  Nothing has really changed, this is the amount he has been having taken off each time for the last 3-4 months and no issues, no swelling/fluid retention until now.  Any ideas why?

Has your husband taken any new meds lately? My husband had swelling in his feet and ankles when he took Minoxidil for high blood pressure and it also happened when he took a "calcium channel blocker" (sorry, can't remember which one but he was told that it was an allergic reaction and that he should never take calcium channel blockers again). Good luck! Hope you guys and the doctor can get to the bottom of it ASAP! Swelling (edema) is never a good sign! Take care! 

[WifeofDiaylsisPatient]

His heart seems to be fine - fully aware about edema and having heart problems as my husband had congestive heart failure back in the mid 90's and got a heart transplant.  He did take a new medicine, Dalisrep, for about 6 days going back about 3-4 weeks ago, but we stopped it quickly as it seemed to increase his anxiety, but I think it was stopped before I noticed any swelling.  The doctor has been notified about the swelling. Maybe he is losing more kidney function but has not complained about not urinating. He does seem to urinate 2-3 times per day.  Agreed, if three days of dialysis in a row does not decrease the swelling, we will seek additional medical attention. 

[Karlise13]

A severe protein depletion can cause edema. Is his albumin really low? Like in the 2's??

[WifeofDiaylsisPatient]

Albumin is around 3.7 as of last blood draw 2.5 weeks ago.  He is at treatment right now, and I believe they have scheduled him to come in tomorrow and the next day.  Hopefully, three days in a row of dialysis will help