Causes of lower extremities edema, less and less nocturia, fatigue and treatment

Question
I have swelling in my lower extremities, ankles, and feet. In terms of more severe edema, less urination at night, more urine, tired people, on June 4, 2020 I went to the hospital to check, the results were as follows:
Echocardiogram: Second valve regurgitation mild mitral regurgitation, mild tricuspid regurgitation, mild aortic regurgitation X-ray: The heart is not enlarged, the aortic arch is dilated. Leg ultrasound: Disseminated atherosclerosis of the lower extremity arteries on both sides, insufficiency of the great saphenous veins on both sides. Abdominal ultrasound: Grade 2 chronic kidney failure, creatinine 157.6, left kidney cyst 10mm long, prostate 37g fatigue and its treatment. Thank you doctor!
Tran Quoc Dac (1936)
Reply
Hello! First of all, let me ask: Has your health improved after examining and taking medicine prescribed by the hospital (have you reduced edema, how is your urination, has your feeling of fatigue improved? ). After summarizing the information you sent, the doctor found:
You have kidney failure (creatinine 157.6) - if you have weight, you will know specifically predict the level - stage of your kidney failure . The prostate gland is enlarged and requires further evaluation for urinary disorders (usually based on - TTL Symptom Score (IPSS). The scale consists of 7 questions with a total score of 35 points. Diseases based on this scale are classified as follows:
Mild urinary incontinence (0-7 points) Moderate urinary incontinence (8-19 points) Severe urinary incontinence (20-35 points) Score) About atherosclerosis: It is noted on Doppler ultrasound of the lower extremities. This indicates that you may have atherosclerosis in other blood vessels, especially coronary, carotid vessels and the doctor's observation. heart is the patient's symptoms: Whether or not there are symptoms of pain in the chest or shortness of breath, whether or not there are symptoms of headache or a history of cerebrovascular accident...
About echocardiography: There is an open condition The valve is mild, but what the doctor is concerned about is your heart function (left ventricular ejection fraction: LVEF, right ventricular function) and importantly, whether or not there is a movement abnormality of the heart wall
About X-ray images g shows dilated aorta, so please add: Do you have high blood pressure (previously diagnosed, have you been on medication and what is your blood pressure now: Systolic blood pressure?/ diastolic blood pressure?; and while measuring blood pressure with electronic blood pressure also take care of your heart rate.
So how to treat?
Before giving a specific treatment plan, the doctor will make an overall assessment and make an accurate diagnosis with the above questionable problems: Cause of edema, degree of urinary disturbance, heart function and atherosclerotic status, thereby making an appropriate treatment plan.
Thank you for trusting and sending the question "What causes lower extremity edema, less and less nocturia, body fatigue and treatment" to Vinmec Health System. If possible, please go to the cardiovascular clinic of the Heart Center - Vinmec Times City International Hospital for more specific examination and advice. Best regards!
Answered by Doctor Le Duc Hiep - Internal Medicine and Cardiovascular Intervention - Cardiology Center - Vinmec Times City International Hospital