Hypervolemia: What you need to know about fluid overload
Hypervolemia is usually a result of an underlying health problem. However, mild hypervolemia can occur after eating foods with too much sodium or during hormonal changes. Mild hypervolemia usually resolves on its own if there are no other health problems.
Hypervolemia is often treatable if caught early, but the underlying cause of hypervolemia should be addressed to keep it from recurring.
Causes of fluid overload
Mild hypervolemia can be caused by eating too much salt or hormonal changes.
Hypervolemia is usually caused by too much sodium (salt) in the body.
When there is too much salt present, the body retains water to balance it.
Usually, hypervolemia occurs because the body has a problem regulating sodium and water, but other causes include certain medications or medical procedures.
Congestive heart failure
Congestive heart failure is a condition in which the heart cannot pump enough blood to meet the body's needs. When the heart's blood pumping ability decreases, the kidneys cannot work as they should, which leads to an excess of fluid in the body.
An article in Cardiac Failure Review found that hypervolemia is common in those with chronic heart failure, and for some people, hypervolemia never goes away completely, even with treatment.
The kidneys help regulate the amount of sodium and fluid in the body, so people with kidney problems are at risk of hypervolemia.
One review states that hypervolemia is relatively widespread in people who have severe kidney problems and are in critical care units in the hospital. The authors of the study suggest that healthcare professionals monitor the fluid levels of these people very carefully because hypervolemia can lead to congestive heart failure, problems with wound healing, and bowel problems.
Another article suggests that hypervolemia caused by heart failure or end-stage kidney disease may lead to sleep apnea.
Cirrhosis of the liver
Hypervolemia may occur when the liver cannot properly store and process nutrients and filter toxins. Liver problems tend to cause fluid retention in the abdominal area and the extremities.
According to an article in the journal Hepatology, fluid accumulation in the abdomen is the most common complication of cirrhosis of the liver. This specific buildup in the abdominal area is known as ascites.
Intravenous (IV) fluids are life-saving when someone is dehydrated or cannot drink adequate fluids, such as after surgery. IV fluids typically contain sodium (salt) and water to replenish the body's fluids and balance the sodium levels.
However, too much IV fluid can result in hypervolemia, especially if other health conditions are present.
One study found that too much IV fluid both during and after surgery was associated with hypervolemia and a higher risk of death after the surgery. The study looked at people undergoing surgery for esophageal cancer.
Premenstrual syndrome (PMS) and pregnancy can cause the body to retain more sodium and water.
This often causes mild swelling, bloating, and discomfort. Pregnant women who notice excessive swelling or bloating should seek medical care, as this may be a sign of high blood pressure.
Medications that cause hormonal changes can also cause hypervolemia. Birth control pills, hormone replacement therapy, and similar hormonal medicines can cause the body to retain too much salt and fluid.
Eating too much salt
The American Heart Association says the average American consumes 3,400 milligrams (mg) of sodium per day — well above the recommended limit of 2,300 mg.
Consuming too much sodium causes the body to retain water. This can result in mild hypervolemia and bloat.
One salty meal is unlikely to cause problems for otherwise healthy people. However, an extreme intake of salt can be life-threatening, especially for young children, older adults, and those with health problems.
Many people with congestive heart failure, kidney disease, or liver problems may be advised to follow a low-salt diet to avoid or minimize hypervolemia.
One symptom of hypervolemia is unexplained and rapid weight gain.
Hypervolemia symptoms may vary depending on where the fluid is collecting and what other health problems are present.
The most common symptoms include:
- unexplained and rapid weight gain
- swelling in the arms and legs
- abdominal swelling, which is common with liver problems
- shortness of breath caused by fluid in the lungs
A doctor may diagnose hypervolemia by carrying out a physical exam to check for swelling. A doctor may also listen to a person's lungs for signs of fluid.
The doctor may also recommend tests to check for sodium in the blood and urine. Because hypervolemia is often caused by other health problems, a doctor may also undertake a comprehensive checkup to look for underlying conditions, such as heart failure, kidney problems, and liver disease.
Diuretics are often prescribed to treat hypervolemia.
There are several approaches to treatment for hypervolemia. One of the most common treatments for hypervolemia is diuretics. Diuretics are drugs that increase the amount of urine the body produces.
However, any underlying health conditions must also be addressed. For instance, someone with heart failure may need to take steps to manage their condition in addition to taking diuretics.
However, research states that diuretics may not work for people with severe kidney problems. Some people will need renal replacement therapies, such as dialysis or hemofiltration.
People with heart, kidney, or liver conditions may also need to follow a reduced-salt diet. This helps keep sodium levels within normal limits, which helps avoid hypervolemia.
People with congestive heart failure may need to limit the amount of fluid they drink each day. A doctor can recommend the proper amounts of fluid and salt intake based on an individual's health history.
When to see a doctor
Some mild bloating after eating a salty meal or during the premenstrual phase of a woman's cycle is normal.
Legs and feet may also experience minor swelling after a long day of standing or walking and on long flights. This is not usually a problem for people in good health and resolves within a few hours.
Anyone experiencing excessive swelling, weight gain, or water retention without an apparent cause should see a healthcare professional, especially if the person has a family history of heart, kidney, or liver problems.
The cause of hypervolemia usually determines a person's long-term outlook. Occasional, mild water retention is not usually serious for those without other health problems.
Hypervolemia related to heart, kidney, or liver disease requires medical attention and careful management.
Following a doctor's advice on diet, medications, or other treatments can help a person reduce uncomfortable symptoms and live a healthier life.