They’re Leaking!

A friend told me he had leaking veins. I immediately had a mental image of blood pouring out of his legs. I thought of legs because he also told me he had swollen feet, which meant the blood was pooling there. While my image may be what you’d expect from someone who writes fiction [in addition to the kidney writing], it wasn’t exactly right. Oh, all right, it was way off the mark.

I know because I went to the trustworthy Cleveland Clinic:

“Venous disease is any condition that affects the veins in your body. Veins are flexible, hollow tubes that are part of the circulatory system that moves blood through your body. Veins bring oxygen-poor blood back to your heart, which pumps your blood. Arteries carry oxygen-rich blood away from your heart.

Veins have flaps (valves) inside that open when your muscles contract. This allows blood to move through your veins. When your muscles relax, the valves close, keeping blood flowing in one direction.

If venous disease damages the valves inside your veins, the valves may not close completely. This lets blood leak backward or flow in both directions.”

That certainly makes more sense than my mental image did. But how could this happen? According to Modern Heart and Vascular:

“When the valves are missing or damaged, and blood leaks back through the affected valves, varicose veins occur. In some situations, weakness in the leg muscles that push blood forward can also add to venous insufficiency.

Venous insufficiency is more frequent in women than in men. It is also more likely to develop in adults over 50 years old.

Some other risk factors include:

• Varicose veins
• Blood clots
• Pregnancy
• Muscle weakness, leg injury, or trauma
• Family history of venous insufficiency
• Smoking
• Swelling of a superficial vein, known as phlebitis
• Obesity
• Cancer
• Being sitting down or standing up for long periods without movement”

You’ve probably noticed that the terms venous disease and venous insufficiency are being used interchangeably. That’s because venous insufficiency is a type of venous disease. To further complicate matters, venous insufficiency is also called chronic venous insufficiency [CVI].  Remember that chronic means long term.

I wondered if there were more symptoms than we already know about. Thank you to Penn Medical for this list:

• “Dull aching, cramping or heavy feeling in the legs.
• Leg swelling.
• Pain that worsens when you stand and improves when you put your legs up.
• Tingling sensation in the legs.
• Visible varicose veins on the surface.

With CVI, you may notice skin changes on the legs. You may have wounds that don’t easily heal, and skin may appear:

• Irritated or cracked, especially if you scratch
• Red, crusty or weepy (stasis dermatitis)
• Swollen
• Thick or hard on the legs and ankles (lipodermatosclerosis)”

I think it’s time to figure out what to do about venous insufficiency. Mount Sinai has quite a few remedies:

“Your provider may suggest that you take the following self-care steps to help manage venous insufficiency:

• Do not sit or stand for long periods. Even moving your legs slightly helps keep the blood flowing.
• Care for wounds if you have any open sores or infections.
• Lose weight if you are overweight.
• Exercise regularly.

You can wear compression stockings to improve blood flow in your legs. Compression stockings gently squeeze your legs to move blood up your legs. This helps prevent leg swelling and, to a lesser extent, blood clots.

When more advanced skin changes are present, your provider:

• Should explain which skin care treatments can help, and which can make the problem worse
• May recommend some drugs or medicines that may help

Your provider may recommend more invasive treatments if you have:

• Leg pain, which may make your legs feel heavy or tired
• Skin sores caused by poor blood flow in the veins that do not heal or recur
• Thickening and hardening of the skin on the legs and ankles (lipodermatosclerosis)

Choices of procedures include:

• Sclerotherapy — Salt water (saline), a chemical solution, or foam is injected into the vein. The vein hardens and then disappears.
• Phlebectomy — Small surgical cuts (incisions) are made in the leg near the damaged vein. The vein is removed through one of the incisions.
• Procedures that can be done in a provider’s office or clinic, such as using a laser, radiofrequency ablation, or a technique that uses a glue/foam to seal the vein.
• Varicose vein stripping — Used to remove or tie off a large vein in the leg called the superficial saphenous vein.”

Okay, let’s say you’re one of those people who just doesn’t deal with medical issues, what could happen by ignoring this condition?  The National Center for Biotechnology Information helped us out here:

“Untreated venous insufficiency results not only in a gradual loss of cosmesis [loss of positive body image] but also in variety of complications, the major ones being persistent pain and discomfort, hemorrhage, superficial thrombophlebitis [an under the skin blood clot], and progressive skin changes that may ultimately lead to ulceration [sore that is slow to heal or keeps recurring] …. Rarely, chronic soft tissue changes may eventually lead to stiffness of the ankle joint, fixed plantar flexion, and periostitis [inflammation of a certain part of the foot].”

Finally, we get to what this has to do with chronic kidney disease. Comprehensive Vascular Care explains:

“Your two kidneys use structures called ‘nephrons’ to filter out excess water and waste products from the blood, which they combine to form urine. By controlling fluid balance, they also control the levels of sodium, potassium, phosphorus, and calcium in the body as a whole.

For the process to work effectively, the kidneys must receive adequate blood flow under proper pressure. If the arteries leading to the kidney are diseased, such as with peripheral artery disease, or blood flow becomes sluggish, such as with chronic venous insufficiency, the kidneys won’t be able to function properly…

Damage to the tiny filtering nephrons can result in what’s called nephrotic syndrome; declining levels of the protein albumin in your blood and increasing levels in the urine can cause fluid to build up and result in edema, most commonly around the ankles and feet. A healthy kidney doesn’t let albumin enter the urine.”

It really is all connected, isn’t it?

Until next week,

Keep living your life!