Swollen legs and ankles: when edema points to the kidneys

Dr. Joan J. Morales Lappot, MD
3 min read · Leer en español

In briefSwelling in the feet, ankles or legs, called edema, is one of the most common reasons people are sent to see me. It has many causes, and the kidneys are only one of them.

Common causes

Too much salt, which makes the body hold water
Kidney disease, especially when protein leaks into the urine (nephrotic syndrome)
Heart failure
Liver disease
Weak leg veins, especially after long periods standing or sitting
Medicines such as amlodipine and some diabetes and anti-inflammatory drugs

Clues that point to the kidneys

Foamy urine, swelling around the eyes in the morning, rising blood pressure or a change in creatinine all suggest the kidneys are involved. A simple urine test for protein is often the most useful first step.

Get care right away if:

Swelling comes with shortness of breath or chest pain
One leg is suddenly swollen, red or painful, which can mean a blood clot
You gain more than 3 pounds in a day or 5 in a week

Call 911 for chest pain, trouble breathing or fainting.

What helps

Cutting sodium is the foundation; water pills work much better when salt is low. Elevating the legs and compression stockings help vein-related swelling. If a medicine is the cause, switching it can be enough. When diuretics are needed, the dose is adjusted carefully, because removing fluid too quickly can strain the kidneys.

Bottom line: Swelling is a clue, not a diagnosis. A urine test, a look at your medicines and less salt solve most cases.

Questions about your kidneys?Call (954) 989-9553