Tag Archives: edema
Ask Dr. Atef about Urine Testing
What is the use of 24 hour urine protein in patients with swelling in their legs or with generalized body swelling? 24 hour urine test in patients with swelling in their legs or with generalized body swelling. What is the use of 24 hour urine protein in patients with swelling in their legs or with generalized body swelling? In certain diseases of kidneys, large amount of protein can pass the kidney filter and find their way to urine. In this setting, the amount of protein in the vessels decreases and this can lead to retention of fluid and swelling in body. A clue that should make a person suspicious of passing large amount of protein in the urine – having “persistent” foamy urine may be a clue toward passing large amount of protein in urine. Foamy urine is shown in the following pictures:
Foamy urine in toilet (source: buzzle)
Foamy urine specimen (source: kidneyfailureweb)
Why the doctor asked for 24 hour Creatinine as well? Each person passes a fixed amount of Creatinine in urine in 24 hours. In all 24 hour urine tests we also ask for 24 hour urine Creatinine. By doing so we can verify if the urine was collected properly or not.
Please read more about Creatinine on my site by clicking here.
Ask Dr. Atef about Swelling
I have noticed swelling in my ankles. The swelling has been there for a few weeks. I am concerned about it. Do you have any advise? Swelling in feet, ankles and lower part of legs is due to leakage of fluid from the vasculature in the soft tissues around the vessels. Fluid makes about %60 of our body weight. It is important to know that this fluid is all placed in different compartments. Two third of this fluid in placed in the cells. The rest of this fluid is outside the cells. These two fluids have different constituents. From the one third which is outside the cell, one fourth of it is in blood vessels and the rest (three fourth of the fluid which is outside the cells) is distributed between the different tissues of the body (the fluid between the cells).
Just for the sake of better understanding imagine if somebody is 160 pounds (lbs). This person will have about 96 lbs of fluid in the body. From this 96 lbs, about 64.3 is inside the cells, 21.2 lbs are between the cells and 10.5 lbs are in the vessels.
Under different conditions the amount of fluid which resides in the area between the cells (interstitial fluid) increases. This excessive amount of fluid in the areas between the cells is called edema.
Edema moves with gravity. This is why if somebody develops edema, this fluid tends to accumulate in the lower part of the body (ankles and legs). And if the person lies flat, this fluid tends to move away from the legs.
This is a simplified way of understanding edematous state.
Now in our example person, when he or she develops edema his or her weight increases. In this case the person’s weight can increase to about 175 lbs or more.
This excessive fluid will show itself mostly in interstitial area and is called edema.
Edematous status requires further work up.
This information is important for patients who have edema (such as in patients with heart failure, kidney failure or liver disease) and take water pills (diuretic).
I will post more info on that on my near future blog posts.
Dr. Atef (Dallas)