Q: I am a 30 years odl kidney patient. I underwent a transplant 5 years back and been on immunosuppressant drugs. My blood parameters were by and large normal. My blood pressure used to be around 160/100 or lower. Unfortunately, I met with an accident. I had a fracture of my right tibia and fibula and cerebral injury. I was in a semi-conscious condition at first but later came to my conscious state. My coma scale was in the scale of 6/15 and had hemiparesis on my right side but later on it was hemihypoaesthesia with a slight limping gait. After physiotherapy my limp improved. Now, though blood parameters are within normal limits, I am having oedema in my left leg, which gives me a lot of mental strain. I am having the same in my right leg too but I think it is due to the fracture/brain injury I suffered. My cyclosporin level is 67 ng/dl. My BP level is 160/100. I am taking Amlodipine (Amlong 5mg) a day. What is the reason for this swelling? Is it due to my BP tablet or due to excess cyclosporin intake or some other reason?

A:There could be several causes of what appears to be bilateral leg swelling. It could be a side effect of medications like amlodipine and steroids. It could also be result of excess fluid retention by your transplanted kidney. Additionally, your BP is poorly controlled which supports the fluid retention process. You have not indicated whether or not you are taking lasix or you have any heart condition. Also, it not clear what caused your kidneys to fail? You should check with your nephrologist if you may benefit from being started on lasix (furosemide) or if it is indeed side effect of the medication. You need tight BP control <130/80) and urinalysis to look for any proteinuria. Additional measures to help control BP include restriction of salt, alcohol and smoking, as well as doing daily exercise and maintaining normal weight.