Managing Swelling Caused by Kidney Disease

Chronic kidney disease (CKD) can have many complications, or health issues that occur along with the condition. A common complication of CKD is swelling (edema) of the legs, hands, or face.^1,2

What is edema?

Edema occurs when tiny blood vessels in the body, also known as capillaries, leak fluid. The fluid builds up in nearby tissues, which leads to swelling.^1,3

You can experience swelling nearly anywhere in the body. But some of the most common areas include:^1,3

• Lower legs or hands (peripheral edema)
• Abdomen (ascites)
• Chest (pulmonary edema)

Edema can have many causes, including:^1,3

• Kidney disease
• Drug side effects
• Pregnancy or premenstrual syndrome
• Sitting for too long
• Eating too much salt
• Lack of protein
• Congestive heart failure
• Problems with veins
• Poor circulation and lymphatic system
• Blot clot in the vein, or deep vein thrombosis (DVT)
• Liver damage or cirrhosis

Chronic kidney disease and edema

The kidneys have many important jobs. Generally, they remove waste from the blood and balance fluid levels.²

Chronic kidney disease means your kidneys do not function at optimal levels. CKD can cause a variety of symptoms, including:^1-3

• Swelling in the feet, ankles, wrist, and face
• Cramping or stiffness
• Shortness of breath
• Headaches
• High blood pressure

Kidney function declines as the disease gets worse. Your kidneys may not be able to remove excess fluid from your body. This can cause fluid and salts in the blood to build up and lead to excess swelling or bouts of fluid retention. Swelling caused by kidney disease usually occurs in the legs or around the eyes.^1,3

In people with CKD, the tiny blood vessels in the kidneys that filter out waste may become damaged. This can lead to nephrotic syndrome, in which lower protein levels in the blood can cause edema.¹

Symptoms of edema

When you have an episode of edema, discuss your symptoms with your doctor. Symptoms may include:^1,3

• Tissue under the skin that looks puffy or swollen
• Shiny or stretched skin
• Skin that looks pitted or holds a dimple after touched
• Swollen belly
• Legs that feel heavy or painful

Contact your doctor right away if you have:¹

• Trouble breathing
• Irregular heartbeat
• Chest pain

These can be signs of fluid buildup in the lungs, or pulmonary edema. This type of edema can be severe and require immediate care.^1-3

Other complications from edema may include:^1-3

• Swelling that gets more painful
• Trouble with walking
• Itchy skin
• Cracked or seeping skin
• Sores and ulcers
• Less blood flow

In many cases, fluid retention is a sign of bigger problems or a chronic health condition. It can affect other organs or lead to heart failure.²

Treatment options for edema

If edema is due to CKD, the kidney disease needs to be treated. Your doctor will monitor your kidney function and recommend ways to slow kidney damage.^1,2

Eating a healthy diet and managing fluids can help reduce swelling episodes. People with CKD may not need to limit fluid intake until their kidneys start failing at stage 4 or 5.^2-4

It is important to tell your doctor if your edema gets worse so that they can identify the cause of the swelling. It might be from a medicine you are taking or another chronic illness. Try these tips for communicating your edema symptoms to your doctor:^2-3

• Write down your symptoms
• Take pictures of the swollen area
• Track your flare-ups, diet, and fluid intake
• Make a list of the medicines and vitamins you take
• Discuss other chronic health conditions
• Make a list of questions for your doctor

Fluid management also depends on whether you are receiving treatment for end-stage kidney disease. For example, dialysis helps reduce swelling by removing excess fluid. It is important to complete each dialysis session and your full treatment plan.²

Tips to manage fluid retention

While it can come and go, mild edema usually resolves on its own in the early stages of kidney disease. Swelling often can be managed with lifestyle and dietary changes, such as:^1-3

• Elevate your legs or area that swells.
• Wear compression socks or gloves.
• Try light exercise to improve circulation.
• Take a water pill.
• Reduce or avoid sodium.
• Cook with herbs and spices instead of salt.
• Decrease fluid intake.
• Massage the swollen area toward your heart.
• Monitor your blood pressure.
• Use lotion on dry, cracked skin.
• Treat all other chronic illnesses.

Living with edema can be uncomfortable and may get worse if you have chronic kidney disease. But you can help manage flares with at-home care, fluid management, and dietary changes. Always talk to your doctor before trying any new treatments for edema or CKD.