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Pitting edema in ankles, profuse sweating. Taken Cipro for flu. History of kidney, bladder and prostate cancer

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Practicing since : 1996
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My husband had cancer of the kidney, bladder urethra and protate. All were removed as of Dec. 2011. He has been healthy since. He takes sodiumm cirate and citric acid solution 3 times a day. Recently he came down with flu like symptoms. Fever of 101, chills, headache, nausea. Family Phys. Asst. checked blood for acidosis and ordered Cipro. After three days he seems to be better, but I am concerned about the slight pitting edema in his ankles and an obvious profuse sweating that has become upsetting to him for several months now. He has gained about 40lbs since his surgery. It is difficult to get him to the doctor unless I can convince him that his symptoms warrant it. Can you give me any insight with this amount of information.
Posted Mon, 10 Sep 2012 in Kidney Conditions
Answered by Dr. Ravi Bansal 2 hours later
Thanks for writing in.
Swelling around ankles can be a sign of kidney disease- dysfunction (if serum creatinine is high) or proteinuria (if urine has protein in high amounts ). But the condition requires an evaluation by a nephrologist and proper management. If the dietary intake is very less and serum albumin levels go down then also swelling can appear. In any case- if the above labs are OK there is not much to worry.

As far as the profuse sweating is concerned, if it is related to meals, it is a sign of autonomic dysfunction and in also seen in diabetics. I would like to know if blood sugars are ok and his blood pressure is within normal limits. Fever and infection could also contribute to sweating.

The weight gain is not just water from oedema but can be due to an increase in the lean body mass The latter is a good sign. But generally weight can increase rapidly after an increase in swelling. This can be differentiated by clinical examination.

As you mentioned that your husband has cancer, I would like to know where the cancer originated. This information would be in the biopsy report and it would be great if you could share it with us.
Also if one of the kidney was removed, your husband effectively has only one functioning kidney. Also, if the bladder was removed , it implies the urine passage of the only working kidney must have been joined to either the intestinal conduit or to the abdominal wall directly.

Such patients are prone to urine infections and metabolic acidosis. Citrate is given to overcome the acidosis which is measured by ABG ( urine culture test. Ciprofloxacin is an antibiotic to control the infection.

His symptoms definitely warrant a visit to his nephrologist.

I hope I have addressed your concerns. Let me know if you have any more questions.

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