Why does chronic kidney disease cause facial swelling?

Facial Swelling is a common presentation of Chronic Kidney Disease. Extra fluid often shows around the eyelids after lying down, then may shift elsewhere as the day goes on. Kidney disease can alter how the body handles sodium and water. Some kidney problems also allow protein to pass into urine; lower protein in the blood can make it easier for fluid to move into soft tissues.

A swollen face has other possible causes, including allergy, infection, dental problems and reactions to medicines. The timing, location and accompanying symptoms help a clinician work out the cause.

Tell your kidney clinician about new swelling and note whether it is worse in the morning, spreads to the ankles or hands, or comes with a change in urine. Follow your existing advice about salt, fluid and medicines. Do not start water tablets, change a prescribed dose, or use herbal products for swelling without medical advice, as these can affect kidney function and body salts.

Seek emergency help immediately if swelling of the lips, tongue or throat occurs, or if facial swelling comes with breathing difficulty, wheezing, faintness or a widespread itchy rash. Arrange prompt assessment for rapidly increasing swelling, reduced urine, severe headache, chest discomfort or shortness of breath.

Could this be fluid retention or protein loss in urine? Do I need a urine test, blood test or medication review? What changes in swelling or breathing should lead me to seek urgent care?