Ankles swelling - drink, but take a diuretic?

[LorrieC]

My ankles have been swelling for a while. Different doctors tell me its from different causes. My cardiologist tells me to take a water pill and I'm in the bathroom every 20 minutes for at least five hours. My internist tells me to drink. Doesn't one cancel the other? The more I drink, the more I go to the bathroom.

[steve680]

Well, I don't know anything about your medical condition, but people with impaired kidney function can retain water more easily than people with healthy kidneys. A diuretic pill increases your urine production to get rid of excess water. There are also ways to increase your urine without a pill:

1) Coffee or tea due to the caffeine, though your body can build up a tolerance to it.

2) Exercise - try to get at least 45 minutes a day of exercise. Also, take frequent breaks as sitting for long periods of time can cause swelling.

3) Eating more magnesium-rich foods.

4) Eating more potassium-rich foods (you may want to talk to a renal dietician about this since you might need to limit your potassium in take),

5) Staying hydrated - Both dehydration and over-hydration can cause water retention. You want to achieve a balance. Drink when you're thirsty and stop when you feel hydrated. If your urine is clear or lightly yellow then that's a good sign that you're hydrated. If it's a dark yellow, that could mean you're not drinking enough water.

6) Eating less salt (packaged/processed foods).

7) Getting enough sleep.

8) Herbs such as parsley, but I wouldn't take any herbs without talking to a doctor about it.

9) Cutting carbs - Carbs cause a rise in insulin, which can increase sodium and water retention.

10) Certain medications can cause water retention - you should review your medications and see if any of them have water retention as a side effect. Also, you can ask your doctor about this as well. A high blood pressure medication such as amlodipine (calcium channel blocker - brand name Norvasc) can cause swelling in the ankles. A doctor might prescribe a medication in spite of the side effects if the good outweighs the negative.

11) Don't smoke or drink alcohol (if that applies).

[LorrieC in reply to steve680]

Steve, I recently started taking amlodipine and it seems my ankles had increased swelling since, so that is interesting. I was also taking meloxicam which causes swelling. I stopped taking it about a week ago. My b/p is always normal since starting amlodipine, but before it was, I had a short bout of systolic hypertension and my ankles seemed to swell more. I thought it might have been due to diastolic heart failure, but doctors don't give me an answer for they don't know.

[eucador in reply to steve680]

Thank you for your clear information

[bootsboots]

I hear you. I have swelling also, and I was offered a water pill, but had the same results you do and decided it was not worth because it did not reduce the swelling much anyway.

[LorrieC in reply to bootsboots]

The diuretic (Lasix) reduces the swelling for a day and then returns the next. I do take spironolactone which is also a diuretic, but I don't have bathroom issues with it and it does not reduce the swelling. Do you know what is causing your ankle swelling?

[TaffyTwoshoes27 in reply to LorrieC]

Lorrie: Have you been diagnosed with kidney disease? Are you on dialysis? Before I started on dialysis, my ankles would from time-to-time swell up (especially when standing or walking too much). My Nephrologist said it is the result of your kidneys not removing excess water from your blood (which also causes the high blood pressure). I take Amlodipine too, but have never been prescribed a diuretic. My brother has some diminished kidney function (not on dialysis), has HBP and his ankles are quite swelled. He is also obese; had his thyroid removed; and is on a C-PAP machine for sleep apnea.

How is you weight? Are you on dialysis?

My Nephrologist and renal nurse check my ankles every appointment I have with them. Remember: excess fluid in your system can also cause heart issues.

When in CKD stage, my fluids were restricted (which includes ANYTHING liquid, like jello, soup, etc.).

In a webinar I listened to this week presented by a Renal Dietician, she said kidney patients shld restrict fluid intake to 32 oz. per day.

I was told by my Renal Nurse that if my blood pressure was consistently staying in the normal levels (under130/90), try not taking the Amlodipine for a couple days. Since I am on 6 days/week dialysis (Home Peritoneal Dialysis), I must take my blood pressure every day. If I eat right and keep my fluids in check, I don't need to take the Amlodipine and have not had any swelling in my ankles for many, many months.

[LorrieC in reply to TaffyTwoshoes27]

Hello,

I found out on my own that I am in stage 3A CKD. I had an US four years ago to check my gallbladder and the radiologist said I had cortical thinning and his impression was "medical renal disease". At the time, my creatinine was normal and my GFR was above 60, so my doctor said he wouldn't worry about it. Since then, I changed doctors and my creatinine kept creeping up. She kept telling me to drink more even though my ankles were swollen. I have showed my ankles to about five doctors and each says something different: CHF, venous insufficiency, and my present doctor said it could be from CKD. He never told me I had it, but I saw the GFR on my labs and asked him and he confirmed it. Since I found out my diagnosis and freaked, I went into tachycardia and I still haven't converted to normal sinus rhythm.

I was about 30 lbs overweight, but since I'm watching sodium and barely eating anything, I am about 20 lbs overweight if even that.

I am going to the DaVita class on Tuesday and to a nephrologist on the 26th. I stopped taking meloxicam and can barely walk due to plantar fasciitis. My doctor said I could still take it and so did one pharmacist; another pharmacist said I should not. From what I read here, I should not be taking it, but I am going to ask if I can take one if I know I am going to walk like at a mall.

I'm curious why you chose home dialysis. Do you do it during the night while you sleep? I'm sorry; I don't know much about dialysis. Are you Stage 4 or 5? When you are on dialysis are you supposed to limit fluids?

I appreciate your reply and please keep in touch. I so appreciate this forum and all the nice, helpful members.

Lorrie