What causes facial swelling due to kidney disease?

Generally, facial swelling caused by kidney disease may be due to factors such as excessive water intake before bedtime, positional influences, acute glomerulonephritis, nephrotic syndrome, or chronic renal insufficiency. It is recommended to seek timely medical attention, identify the underlying cause, and undergo symptomatic treatment under a physician's guidance. Detailed explanations are as follows:

1. Excessive water intake before bedtime: Patients with kidney disease have weakened kidney function. Drinking large amounts of water before sleep increases the kidneys' excretory burden, causing water retention in the body and facial edema upon waking, which may improve with activity. Adjusting water intake timing, reducing fluid consumption 1-2 hours before bedtime, and controlling total daily water intake according to urine output and medical advice can help avoid exacerbating water and sodium retention, thereby gradually relieving the swelling.

2. Positional influences: During prolonged lying at night, the face remains in a dependent position. When kidney filtration function declines, water may accumulate in the loose facial tissues, causing facial swelling noticeable upon waking, which gradually subsides after standing. Elevating the head appropriately during sleep can reduce facial fluid accumulation. Engaging in moderate daytime activity promotes blood circulation and helps water metabolism, alleviating facial edema.

3. Acute glomerulonephritis: Impaired glomerular filtration function reduces water and sodium excretion, leading to water and sodium retention, causing facial swelling accompanied by oliguria, hematuria, and hypertension. Patients should rest in bed, follow a low-salt diet, and take medications as directed by a physician, such as sodium penicillin for infection, hydrochlorothiazide tablets, nifedipine tablets, and other drugs for treatment. Once the inflammation subsides and kidney function recovers, facial swelling will gradually disappear.

4. Nephrotic syndrome: Large amounts of protein are lost through urine, leading to decreased plasma albumin levels and reduced plasma colloid osmotic pressure. This causes water to seep into the interstitial spaces, resulting in facial edema accompanied by massive proteinuria and hyperlipidemia. Patients should follow a low-salt, low-fat diet with high-quality protein and take medications as directed by a physician, such as prednisone tablets, cyclophosphamide tablets, furosemide injection, to reduce proteinuria, supplement albumin, and promote diuresis. As the condition improves, facial swelling will subside.

5. Chronic renal insufficiency: Gradual decline in kidney excretion function leads to accumulation of metabolic waste and excess water, causing facial swelling accompanied by fatigue, poor appetite, and anemia, with prolonged duration of edema. Patients should follow a low-protein diet and limit sodium intake. As directed by a physician, patients may take uremic clearance granules and renal failure capsules to improve kidney function, while using spironolactone tablets, torasemide injection for diuresis and edema reduction. In severe cases, hemodialysis may be required to remove excess water and toxins from the body, alleviating facial swelling.

Daily monitoring of urine output and weight changes, recording the severity and duration of edema, will help physicians evaluate the condition. Maintaining a regular lifestyle, avoiding fatigue and infections, and reducing factors that damage kidney function can help stabilize the condition and alleviate symptoms such as facial swelling.