Edema (cont.)

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Why do people with kidney disease have pitting edema?

Edema forms in people with kidney disease for two reasons:

  1. A heavy loss of protein in the urine
  2. Impaired kidney (renal) function

What causes pitting edema by heavy loss of protein in the urine?

In this situation, the people have normal or fairly normal kidney function. The heavy loss of protein in the urine (over 3.0 grams per day) with its accompanying edema is termed the nephrotic syndrome. Nephrotic syndrome results in a reduction in the concentration of albumin in the blood (hypoalbuminemia). Since albumin helps to maintain blood volume in the blood vessels, a reduction of fluid in the blood vessels occurs. The kidneys then register that there is depletion of blood volume and attempt to retain salt. Consequently, fluid moves into the interstitial spaces causing pitting edema.

What medications treat pitting edema caused by heavy loss of protein in the urine?

The treatment of fluid retention in these people is to reduce the loss of protein into the urine and to restrict salt in the diet. The loss of protein in the urine may be reduced by the use of ACE inhibitors (angiotensin-converting enzyme inhibitors) and angiotensin receptor blockers (ARB's). Both categories of drugs, which ordinarily are used to lower blood pressure, prompt the kidneys to reduce the loss of protein into the urine.

ACE inhibitor drugs include:

Angiotensin receptor blockers include:

Certain kidney diseases may contribute to the loss of protein in the urine and the development of edema. A biopsy of the kidney may be needed to make a diagnosis of the type of kidney disease, so that treatment may be given.

Medically Reviewed by a Doctor on 11/13/2015

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Edema - Effective Treatments Question: What kinds of treatments have been effective for edema?
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Edema - Signs and Symptoms Question: In addition to swelling, what were your signs and symptoms associated with edema?
Edema - Salt Intake Question: If you've had edema, in what ways do you adjust your salt intake?
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