Chronic kidney disease (CKD) is an underrecognized public health crisis, causing more deaths than breast cancer or prostate cancer. It affects some 37 million people in the US (more than 1 in 7 adults), of which about 90% don’t know they have a problem, as the disease is asymptomatic in its early stages. It’s also linked to two other major diseases: 1 in 3 adults with diabetes and 1 in 5 adults with high blood pressure may also have kidney disease. All three conditions can lead to edema (swelling) in the legs.
At Comprehensive Vascular Care, our team of vascular experts sees many cases of edema of the legs in our Southfield and Novi, Michigan offices. The key is to get at the cause of the edema to ensure proper treatment of the underlying condition. Here’s what you need to know about the link between kidney disease and your swollen legs.
What causes edema in the legs?
The problem with swollen legs is they can be caused by a wide variety of things, from the utterly banal to the incredibly serious. If you sit or stand for too long — or even if you wear pants that are too tight! — fluid can accumulate in your legs. These are easily remedied situations. You can also develop frequent leg swelling if you’re overweight, obese, or pregnant, as the pressure from above pushes the fluid down into your legs.
Persistent leg swelling, though, may be a warning sign of an underlying medical condition, such as:
- Heart disease
- Chronic venous insufficiency (CVI)
- Deep vein thrombosis (DVT)
- Heart inflammation (pericarditis)
- Diabetes
- Kidney disease or kidney failure
- Pulmonary hypertension
The role of your kidneys
Your two kidneys use structures called “nephrons” to filter out excess water and waste products from the blood, which they combine to form urine. By controlling fluid balance, they also control the levels of sodium, potassium, phosphorus, and calcium in the body as a whole.
For the process to work effectively, the kidneys must receive adequate blood flow under proper pressure. If the arteries leading to the kidney are diseased, such as with peripheral artery disease, or blood flow becomes sluggish, such as with chronic venous insufficiency, the kidneys won’t be able to function properly.
What causes kidney disease, and what are the complications?
The primary diagnosis in 76% of kidney failure cases from 2015-2017 was either diabetes or high blood pressure, indicating the conditions are linked. If you have kidney disease, you’re at increased risk for cardiovascular disease and death, no matter if symptoms are present or not. In addition, cardiovascular disease can cause kidney disease if blood pressure rises too high.
Most people don’t have symptoms until the disease is advanced, but when they occur, they’re often from the buildup of waste material in the blood. You’re likely to develop anemia, weak bones, malnutrition, and nerve and blood vessel damage, in addition to hypertension. The problems develop slowly, but they ultimately lead to kidney failure, which can happen without warning. Once the kidneys fail, you need either dialysis or a kidney transplant to stay alive.
The kidney-swollen legs connection
Damage to the tiny filtering nephrons can result in what’s called nephrotic syndrome; declining levels of the protein albumin in your blood and increasing levels in the urine can cause fluid to build up and result in edema, most commonly around the ankles and feet. A healthy kidney doesn’t let albumin enter the urine.
If kidney disease causes edema, but so does CVI, DVT, and other vascular disorders, how can you tell which is causing the problem? Part of the answer is the conditions are linked, so you could be having symptoms of both. The rest of the answer lies in the testing.
CKD can be revealed by using two tests:
- Blood test: checks creatinine concentration; as kidney function decreases, creatinine increases
- Urine test: checks for albumin in the urine; presence indicates failing kidney filtration
If you notice swollen legs and ankles, you need to get them checked out to determine the cause. Comprehensive Vascular Care can provide thorough vascular testing to determine which parts of your circulatory system are affected, and blood tests to determine if kidney disease is partly to blame. Give the office a call at either location to set up a consultation with one of our vascular experts, or book online with us today.
