[45F] Experiencing swelling, burning feet, and tinnitus

Patient Description

A 45-year-old female is experiencing swelling and a burning sensation in her legs and feet, which also present with redness and pain. These symptoms began approximately one week ago and worsen in the evening, though they are somewhat alleviated by sitting and elevating her feet. Additionally, she reports a high-pitched ringing in her ears, described as slightly more than mild, without any associated hearing loss or recent exposure to loud noises. The patient also experiences chest pain, shortness of breath, and fatigue, feeling more tired and weak, which have all been present for about a week. Her medical history includes stage 4 kidney disease, diagnosed five years ago. Current medications include Hydralazine, Nifedipine, and Lasix (Furosemide), with no known allergies or adverse reactions to medications.

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Arora's Assessment

What might be happening

Based on your symptoms and medical history, here are some possibilities:

  • Kidney Disease Progression: As you have stage 4 kidney disease, your symptoms may be related to the progression of this condition. Kidney disease can cause fluid retention, leading to swelling in the legs and feet. It can also cause fatigue and shortness of breath. The burning sensation in your feet could be related to peripheral neuropathy, a common complication of advanced kidney disease.

    • Treatment typically involves managing symptoms and slowing the progression of the disease. This can include medications, dietary changes, and in some cases, dialysis or kidney transplant.
  • Medication Side Effects: Hydralazine, Nifedipine, and Lasix (Furosemide) can all cause side effects that may explain some of your symptoms. For example, Lasix can cause dehydration, which could contribute to your fatigue and tinnitus (ringing in the ears).

    • If you suspect your symptoms are due to medication side effects, you should discuss this with your doctor. They may be able to adjust your dosage or switch you to a different medication.
  • Heart Disease: Given your history of kidney disease, you are at a higher risk for heart disease. Symptoms of heart disease can include chest pain, shortness of breath, and swelling in the legs and feet.

    • Treatment for heart disease can include lifestyle changes, medications, and in some cases, surgery or other procedures.

What you can do

Given your symptoms and medical history, it's important to seek medical attention as soon as possible. Here are some steps you can take:

  1. Contact your doctor: Given the severity and combination of your symptoms, it's important to contact your healthcare provider as soon as possible. They can provide a formal assessment and order relevant tests if necessary.

  2. Monitor your symptoms: Keep track of your symptoms and any changes, including when they occur, what makes them better or worse, and any new symptoms. This information can help your doctor in diagnosing and treating your condition.

  3. Stay hydrated: Unless advised otherwise by your doctor, make sure to drink enough fluids. This can help prevent dehydration, which can worsen your symptoms.

  4. Rest and elevate your legs: As you've found, resting and elevating your legs can help reduce swelling and discomfort.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe chest pain or discomfort
  • Trouble breathing or shortness of breath
  • Fainting or loss of consciousness
  • Severe or worsening swelling in your legs or feet
  • Changes in your mental status, such as confusion or difficulty staying awake

Remember, while I strive to provide accurate information, I'm not a doctor. Please consult with a healthcare professional for a formal diagnosis and treatment.

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8 mo ago


People Also Ask


What causes swelling and a burning sensation in the legs and feet?

Swelling and a burning sensation in the legs and feet can be caused by fluid retention, often due to kidney disease, heart issues, or medication side effects. Peripheral neuropathy, a complication of advanced kidney disease, can also cause burning sensations.


Can kidney disease cause fatigue and shortness of breath?

Yes, kidney disease can lead to fluid retention and anemia, both of which can cause fatigue and shortness of breath. As kidney function declines, the body may struggle to remove excess fluid and waste, leading to these symptoms.


What are the potential side effects of Hydralazine, Nifedipine, and Lasix?

Hydralazine can cause headaches, dizziness, and palpitations. Nifedipine may lead to swelling, dizziness, and flushing. Lasix (Furosemide) can cause dehydration, electrolyte imbalances, and tinnitus. It's important to discuss any side effects with a doctor.


How can heart disease be related to kidney disease?

Kidney disease can increase the risk of heart disease due to shared risk factors like high blood pressure and diabetes. The kidneys and heart are closely linked, and dysfunction in one can affect the other, leading to symptoms like chest pain and shortness of breath.

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