Hypervolemia, also known as fluid overload, is the retention of fluid by the body. Patients with cardiovascular problems, renal failure, and liver issues often experience retention of fluid by the body.
What is Hypervolemia?
Hypervolemia is a medical complication in which the body starts retaining excessive fluid. It is characterized by swelling, I disproportionate increase in weight, and aggravation of other ailments. The increase in extracellular fluid content is caused by increased levels of sodium in the intravascular compartments.
Hypervolemia is usually caused by an underlying medical condition that causes fluid retention. Patients suffering from diseases such as kidney failure, cardiovascular issues, and liver failure are prone to developing hypervolemia. Bad diet and habits such as smoking, high intake of salt, over medication, and in some cases, IV solutions
Symptoms of Hypervolemia
Patients already suffering from diseases such as Chronic Kidney Disease (CKD), blood pressure (BP) issues, and cardiovascular diseases are prone to developing hypervolemia. However, a proper diagnosis can easily identify it and assist in formulating the right treatment. If you have recently noted any of the following symptoms, consider a medical checkup.
Increased Weight
You will feel you have gained weight, which will appear in the form of your body swelling.
Edema
Your feet and ankles will be swollen. The swelling can also appear on your face and wrists.
General Discomfort
Issues such as bloating, cramps, migraines, etc. are also signs of hypervolemia.
Blood Pressure
Chronic blood pressure patients should always keep their health in check, as excessive blood fluid can further increase it.
Breathing Issues
Your stamina will weaken and breathing will come in short gasps after a little exertion. This is caused by the increased fluid in blood entering the lungs.
Cardiovascular Issues
You will begin developing cardiovascular and heart problems or your existing ones will get worse. This happens because the increased fluid levels cause fluctuations in heartbeats and blood pressure in the cardiovascular system. It also damages the heart muscles as there is an imbalance in their fluid levels.
Main Causes of Hypervolemia
The main cause of hypervolemia can be traced to the failure of the body’s regulatory mechanisms. Statistically, kidneys are often diagnosed as the root cause of it. The following health issues contribute towards developing hypervolemia:
Congestive Heart Failure (CHF)
The overall efficiency of your body’s fluid retention falls rapidly as the heart weakens. The kidneys and other organs are unable to regulate fluid levels as they do not receive a sufficient supply of blood.
Cirrhosis (liver scarring)
The liver has a significant role in detoxification and maintaining chemical balance. Cirrhosis reduces and sometimes ceases the liver’s ability to detoxify. It is primarily caused by alcoholism and diseases such as hepatitis.
Kidney Failure and Nephrotic Syndrome
Your kidneys are the chief organ for maintaining osmoregulation. Kidney failure or any condition that impacts it will cause an imbalance in fluid retention.
Pregnancy
In some cases, pregnancy can also contribute to hypervolemia. As the mother experiences changes in her body, she naturally has fluctuating hormones, which can at times lead to fluid retention.
Injuries and Surgeries
Serious injuries or surgical procedures, as the patient is unable to properly excrete sodium because of disruption in fluid regulation mechanisms.
Diagnosing Hypervolemia
Hypervolemia is caused by several reasons; therefore, several tests are required to properly identify its root cause. Since renal failure is the most common symptom, the doctors will test whether the urinary sodium content is greater than 20 mEq/L. In cases of cirrhosis, nephrotic syndrome, or heart failure, it should not be above 10 mEq/L.
The following tests are most commonly performed when diagnosing hypervolemia:
Physical Examination and Patient History for Hypervolemia
Examining patient history along with conducting various examinations e.g. electrocardiogram, chest radiograph, etc. is a widely used strategy to diagnose hypervolemia. Performing a varying number of tests helps in forming a correlation between the disease and underlying medical conditions.
Chest Radiography
Chest radiography is balanced between being the fastest and most accurate for diagnosing hypervolemia, hence it is extensively used today. The radiograph highlights sign of alveolar edema, dilated upper lobes, and, enlarged pulmonary artery.
However, chest radiographs can return negative for patients with late-stage heart failure. This necessitates that the patient’s history be reviewed and other tests are conducted along with chest radiography.
Thoracic Ultrasound
Thoracic ultrasound detects B-lines that point towards fluid in the alveoli. They have been proven to have a strong correlation with CHF. The ultrasound reflection on the edema-affected subpleural interlobular septa displays “comet-tail images” in the presence of extravascular lung water.
Natriuretic Peptides
Hypervolemia increases the count of brain natriuretic peptide (BNP). However, it can also be affected by conditions such as myocardial infarction, obesity, and renal failure. They are especially useful for eliminating heart failure diagnosis from possible reasons for hypervolemia.
Can Hypervolemia Develop Secondary Conditions?
Hypervolemia, if left untreated, can become the contributing factor for other diseases. The imbalance in bodily fluids can have many negative effects that can propagate throughout the body. These problems can include:
Pericarditis
Inflammation of the two pericardium layers. It can increase the amount of pericardium fluid in between them, which normally exists to control friction between them. Symptoms include heart palpitations, chest pain, and shortness of breath.
Delayed Healing
The increased fluid levels compromise the body’s ability to heal wounds. As a result, any wounds you have will take more time than usual to heal.
Damage to Living Tissue
Your muscles and living tissues will sustain damage due to hypervolemia. The living cells, unlike plant cells, do not have a cell wall. The increased osmotic pressure will cause them to burst, which will only increase with time.
Inefficient Digestive Tract
Fluid levels are critical for an efficient digestive system. Your digestion will be compromised as a result of hypervolemia. For example, your intestines will be unable to properly absorb nutrients from the food.
Treatment of Hypervolemia
Your treatment starts with a proper and detailed diagnosis since hypervolemia is caused by a host of medical issues. Treating these issues is how hypervolemia is cured for the long-term.
However, the main problem is the abnormally high fluid levels in the blood, and initial treatment always starts from here. You will be administered standard diuretics combined with medication to naturally reduce bodily fluid. If your case is severe, then the doctors may opt for dialysis to stabilize your condition. You may undergo a paracentesis procedure where fluids will be drained from the swollen body part.
The doctors will prescribe you a dietary change, which will be marked with low sodium and fluid intake. There will also be a lower caloric count with the elimination of simple sugars and processed foods. The addition of complex carbohydrates will promote the body to utilize water for digestion.
You will also receive recommendations to modify your lifestyle. Depending on your condition, you might be given recommendations for cardio exercises that promote sweating. Some patients are recommended to attend saunas, as they drastically increase sweating and facilitate in excreting sodium.
The lifestyle changes are entirely dependent on your current health. For example, a patient with a weak heart most often not be recommended cardio exercises as it will further strain their heart.
General Outlook of Hypervolemia
You must take care of your underlying conditions just as diligently as treating hypervolemia. If you have high blood pressure or heart problems, then you must practice a healthy lifestyle and take medication for your treatment. The primary objective of hypervolemia is to find the underlying issues and get them under control.