Kidney disease and shortness of breath

When the kidneys remove less fluid, extra water can collect in the body and sometimes affect the lungs. Kidney disease can also be associated with anaemia, which reduces the blood's oxygen-carrying capacity and may cause tiredness, weakness or breathlessness with activity. Blood pressure and heart problems may add to the strain.

Breathlessness is not specific to kidney disease. Asthma, acute bronchitis, COPD, bronchiectasis, angina, atrial fibrillation and severe allergic reactions can also cause it. The timing matters: breathlessness that is worse when lying down, wakes you at night, or appears suddenly should not be self-diagnosed.

Stop strenuous activity, sit upright and loosen tight clothing. Note when the breathing difficulty began, whether it occurs at rest or with movement, and whether there is cough, fever, chest pain, swelling or a change in urine output.

Take kidney and heart medicines exactly as prescribed, and do not increase diuretics or restrict fluids on your own. Arrange prompt medical review for new or persistent breathlessness. Assessment may include listening to the lungs, checking oxygen level and blood pressure, and reviewing blood tests, medicines and fluid balance.

Call emergency services for severe or sudden breathlessness, blue or grey lips, inability to speak in full sentences, fainting, new confusion, coughing blood, or chest pressure or pain. Treat breathing difficulty with facial or throat swelling, wheezing or sudden dizziness as an emergency because it may be anaphylaxis.

Seek same-day care if breathlessness is getting worse, occurs at rest, is worse when lying down, or comes with rapidly increasing swelling, fever, palpitations or very little urine. Do not wait for a routine kidney appointment when breathing is affected.

Ask whether fluid retention, anaemia, a medicine effect or a heart or lung condition could explain the symptom. Ask what oxygen or symptom changes should prompt emergency help, and whether you need blood tests, a chest assessment or a review of your fluid plan.